Primary care physician attitudes regarding sexually transmitted diseases

Background. Primary care physicians see the majority of patients with sexually transmitted diseases (STDs), but little is known about their attitudes regarding STD-related issues. Goal: The study goal was to determine the attitudes of primary care physicians toward STD-related issues, to determine physicians' characteristics associated with attitudes, and to examine the relationship of attitudes to STD counseling practices. Study Design: A cross-sectional survey was mailed to randomly selected primary care physicians in Pennsylvania. Results: Of 1054 eligible physicians, 541 (51%) responded. Although most physicians were comfortable discussing sex-related issues with their patients (89%), many believed their STD counseling was ineffective (70%), their medical school STD training was inadequate (48%), or that they were not responsible for STD preventive services for their patients (43%). Overall, STD-related attitudes were more positive among physicians who were female, worked in clinic settings, and received adequate training in STDs. More positive attitude scores were significantly associated with performance of six specific risk-assessment and counseling behaviors. Conclusions: Many physicians reported low confidence, limited responsibility, and time barriers that may affect their STD-prevention practices. Interventions that influence STD-related attitudes may improve STD-prevention practices by primary care physicians.