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Sex Transm Infect doi:10.1136/sti.2007.028050

Does physician bias affect the quality of care they deliver? Evidence in the care of STI

  1. Asaduzzaman Khan (a.khan2{at}uq.edu.au)
  1. The University of Queensland, Australia
    1. David Plummer
    1. University of the West Indies, Trinidad and Tobago
      1. Rafat Hussain
      1. University of New England, Australia
        1. Victor Minichiello
        1. University of New England, Australia
          • Published Online First 1 November 2007

          Abstract

          Background: Primary care providers are well placed to control the spread of STI; however care is likely to be influenced by their attitudes and beliefs. The present study investigates the relationship between general practitioner's (GP) self-reported level of comfort in dealing with patients with STI and the care they deliver.

          Methods: A postal survey was conducted using a stratified random sample of 15% of GPs practicing in New South Wales, Australia to assess practitioners'management of STI. A total of 409 GPs participated in the study yielding a response rate of 45.4%.

          Results: Although over two-thirds (69-72%) of GPs were comfortable in managing STI in heterosexual or young patients, fewer than half (40-46%) felt comfortable caring for patients who were sex workers, Indigenous, people who inject drugs, gay or lesbian. Practitioners who were comfortable were more likely to offer sexual risk assessment, safe-sex counselling, and less likely to report limited ability to influence patients' risk behaviours. Practitioner discomfort was positively associated with reporting constraints in sexual history taking and the need for training in sexual health.

          Conclusions: Practitioners' care and support for patients with STI are influenced by their inexperience, lack of skills, and/or attitudes. Reasons for GP discomfort in managing STI patients need further exploration as does its impact on patient care.

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