Background: Our understanding of healthcare professionals' competence level in both their sexual history taking practices and their attitudes in addressing sexual health concerns of patients in middle and old age is lacking. This research aimed to assess primary care physicians' (PCPs) knowledge, attitudes, and sexual healthcare practices toward patients who are ≥45 years in Trinidad and Tobago.
Materials and methods: A self-reported survey instrument assessing clinical sexual health knowledge, attitudes, and practices was administered nationwide to all registered PCPs (n = 155) in the public healthcare service. Descriptive and inferential statistical analyses were conducted using STATA.
Results: PCPs, who were foreign medical graduates, middle-aged, male, and worked in urban centers, had improved odds of discussing sexual health with middle-aged and older patients. PCPs with any training in sexual health communication or sexual history taking were three times more likely to initiate a sexual health discussion or take a sexual history. Over 90% of physicians reported taking a sexual history only if the discussion was patient initiated and over 50% of PCPs indicated they will not ask these older patients about their sexual orientation, sexual partners, sexual abuse, or violence.
Conclusions: Even though PCPs reported having a positive willing attitude toward offering sexual health care to these patients, they had a low level of knowledge of sexual function in later life and inconsistent sexual history taking practices. There is a great need for training physicians' on sexual health communication and history taking and on sexual function in older adults.
Keywords: Caribbean; Trinidad and Tobago; knowledge attitudes and practices; middle age; old age; primary care; sexual health; sexual history taking.