Sexual Health: The Missing Link in Primary Care

Health promotion and disease prevention are hot topics in primary care these days. With changes in healthcare, employers are being rewarded for keeping their employees low risk for chronic illness. Incentives include discounts for non-tobacco users and deposits into the health savings account for having low cholesterol, A1C, and regular Blood Pressure checks to reduce Hypertension.

Healthcare incentives are a great way to encourage a healthier lifestyle, and hopefully over time statistics will show they work to reduce healthcare costs long term. However, I believe these measures omit an incredibly important aspect of a person’s overall health. Too often people overlook sexual health when discussing health promotion and risk reduction.

With Atlanta having one of the highest rates of new HIV diagnoses and other STI transmissions it is imperative we include sexual health in the overall discussion in primary care.

Promoting HIV Prevention with PrEP

Pre-exposure prophylaxis (PrEP) is a daily oral prescription medication (Truvada) used for the prevention of HIV infection. Commercial healthcare insurance providers cover PrEP, and many state funded programs are available to improve access to PrEP. However, many primary care providers have little information on what PrEP is, or think it is just for men who have sex with men. Arming providers with the information they need to prescribe and manage PrEP will allow patients greater access to HIV prevention.

Having conversations about sexual health with your patient may uncover concerns about HIV prevention and also other potential sexual health risk factors. With the rise of antibiotic resistance, it is important to emphasize all STI prevention along with HIV. PrEP advocates also promote barrier methods of STI prevention. It’s important for patients to know they have options.

Be Open with Your Primary Care Provider

Primary care providers, talk to your patients about their sexual health. Ask who they are sleeping with and what kind of behaviors they are engaging in, because preventing HIV and STIs is as important as reducing the risk of coronary artery disease.

Patients, if your primary care provider is not having these discussions with you then bring it up during your next visit. If you do not feel comfortable having these discussions with your provider, it may be time to seek out a new one, because understanding the whole picture of your health is critically important.

If you know anyone who is interested in starting on PrEP for HIV prevention, or wants to know more, feel free to contact me.

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