Discussing STIs with Patients
By Sinclair Booker McCracken, MD, IFMP
As healthcare providers, we must give careful consideration to our patients’ sexual health, as it significantly impacts their overall well-being. However uncomfortable these conversations may be for patients and providers alike; they are necessary to better our community’s health. Left untreated, sexually transmitted infections (STIs) often result in long-term health complications, many of which are preventable. Creating opportunities for intervention is one way we can work to prevent further disease transmission and find treatment for those already affected.
Unfortunately, Hampton Roads has some of the highest STI rates in the nation. According to CDC reports from 2019 and 2020, we have the second-highest rate of chlamydia and the third-highest rate of gonorrhea. The good news is that while we’re seeing more positive results, these numbers indicate that our area is actively screening for STIs. More people in the higher risk range are getting tested, finding treatment, and stopping the spread, but that doesn’t mean the work is done.
Building relationships with patients based on trust and education is crucial for detecting and preventing STIs. When patients feel heard and understood, they are more willing to share health information with their providers without fear of judgment or criticism. Often, sexual health education is a balancing act. As providers, we are obligated to communicate the dangers of high-risk behavior, while also maintaining a respectful patient-provider relationship.
When taking a detailed sexual history, be sure to ask about the 5 “Ps”: partners, practices, protection from STIs, past history of STIs, and pregnancy intentions. Try to remain empathetic, open and honest. Help patients understand what behaviors could be putting their sexual health at risk, what to do should they suspect they’ve been exposed to an STI, and what treatment or prevention options are available. Not all patients respond the same way when discussing their sexual health. Determining what techniques work best for our patients requires judgment free from bias and personal belief. Consideration of a patient’s gender identity, race/ethnicity, culture, and other unique characteristics will yield a more effective intervention.
Starting these conversations with patients can be challenging, especially for new patients who haven’t had opportunities to place their trust in our care. Providers are in an important position because many of our patients feel safe with us. They trust us to have their best interests at heart when we make recommendations. As rates of STIs in our area increase, creating a safe space for patients to talk and ask questions is one more way we can work to curtail disease.
Sinclair Booker McCracken, MD, IFMP, is a Board certified family medicine physician and certified functional medicine practitioner with TPMG Thimble Shoals Family Medicine in Newport News. When diagnosing each patient, she relies on a detailed understanding of the patient’s genetic, biochemical, and lifestyle factors; leveraging that data to direct personalized treatment plans that lead to improved patient outcomes. mytpmg.com
