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Reviewed research
Authors Latreille S, Collyer, A, and Temple-Smith, M.
Review Date July 2014
Citation Aust Fam Phys 2014; 43(4): 217-221
Background
Young men are vulnerable to poor sexual health. Risk taking behaviour is thought to peak at 15-16 years of age, and despite 25-50% of people this age being sexually active, only one in four believe they are at risk of a sexually transmitted infection. Young men go to a general practitioner (GP) less frequently than do women and older men, and it has been estimated that less than 10% of Australian GPs take a sexual history from young heterosexual patients. In order for health professionals to facilitate optimal sexual health in young men (and their sexual partners), research is needed to investigate the knowledge and attitudes of young men to sexual health and GPs.
Aim
The aim of this study was to investigate whether young Victorian men feel comfortable discussing their sexual health with a GP.
Methods
Young men aged 16-25 years from two educational institutions were invited to participate in semi-structured interviews. The interview was not centred around the individual’s experience but rather their thoughts on what the predominant view of their peer group was. Interviews were audio-recorded, transcribed into Microsoft Word, and thematically analysed.
Result
Thirty-one interviews were conducted which lasted 10-16 minutes. Participants talked about how they felt discussing sexual health with a GP, and about their knowledge of contraception and STIs. Almost all participants believed it would be acceptable for a GP to discuss sexual health with them in an unrelated consultation. Those who did not believe this would be acceptable were not aware that sexually transmissible infections (STIs) could be asymptomatic. Nearly all men did not think they would bring up sexual health without first having a related symptom. Most young men stated a preference for a male GP, preferably young or middle aged; some preferred a female GP or stated no preference. Many of the interviewed men were not aware that adolescents can see a GP without their parents.
Many young men overstated the efficacy of condoms and said the use of the withdrawal method was common, with their knowledge of the risks of this method being variable. While some were aware that an STI test was usually a urine test, many incorrectly thought it would always involve a genital examination or swabs. Many of the men were not aware that STIs could be asymptomatic and none mentioned long-term complications, such as infertility in women. The younger participants demonstrated immaturity and poor decision making around sexual health while older participants reflected upon previous such behaviour.
Conclusion
Young men are comfortable with their GP providing them with sexual health information, but they feel unable to bring it up themselves. Many young men demonstrate lack of knowledge, apathy and immaturity around sexual health. The authors of this study outline implications for general practice including:
- All GPs should broach the topic of sexual health with all young men whenever possible; female GPs may wish to offer a follow-up with a male colleague
- GPs should offer sexual health education to all young men rather than assessing their knowledge
- Sexual health may be best raised by framing it as a government push for testing in all men of their age group while mentioning confidentiality, and offering an STI test (emphasising that it is just a urine test) and brief information on contraception and STIs.
Points to Note
- This is the first Australian qualitative study to examine how young men feel about sexual health and GPs.
- Most young men in this study believed it to be acceptable for their GP to discuss sexual health with them but they are not comfortable to bring this up themselves.
- Many of the participants demonstrated lack of knowledge, apathy and, in the younger men, immaturity around sexual health.
- Due to ethics requirements, it was not possible for the authors to obtain details on participants’ sexual orientation and activity. It was therefore difficult to ascertain the variability of participants (a key component of qualitative research).
- This study did not address men’s views about the impact of their own sexual health on their partner/s. Such views may affect how young men feel about discussing their sexual health with their GP.
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