Friday, July 13, 2007
This presentation is part of : Initiatives for the Chronically Ill
Margaret Louis, PhD, RN, BC and Cheryl A. Maes, MSN, RN, APRN, BC. School of Nursing, University of Nevada, Las Vegas, Las Vegas, NV, USA
Learning Objective #1: The learner will be able to state the main barriers to sexual history taking by Advanced Practice Nurses.
Learning Objective #2: The learner will be able to discuss the key topics or questions that need to be included in sexual history taking.




To identify whether APNs take sexual histories from their clients 50 and older and answer 5 research questions related to: the percentage of APNs who take sexual histories, and what benefits and/or barriers they see in relation to SHT from clients 50+, one of the fastest growing groups diagnosed with HIV/AIDS.


The practice of APNs, as well as other health care providers, is based on many factors that can be reflected in how he/she sees the cost and benefit of a certain action. Stokes and Mears (2000) identified obstacles and barriers faced by the practice nurse when taking a sexual health history. Pender's Health Belief Model (HBM) (Pender, 2006) clearly reflects this in the ‘barriers' and ‘benefits' judged for given behaviors or actions.

The HBM is appropriate to assess whether the advanced practice nurse identifies the benefits of SHT to outweigh the barriers. 


The survey design involved a stratified random sample of 500 members of the American Academy of Nurse Practitioners who were mailed a questionnaire on SHT practices. The questionnaire items were adapted from Stokes and Mears (2000) and Gerbert et al. (1998) and also reflect the HBM.


The sample responses indicate: 29% identified no barriers or constraints to SHT, 43% identified two or more barriers or constraints, 2% always while 23.4% never or seldom assess sexual practices. Lack of time was the most frequently listed barrier.


Considering the increase in HIV/AIDS in persons 50+ and that only 2% always assess for sexual practices is a concern. APNs do have first line of defense and intervention potential for prevention and identification of sexually transmitted diseases in the 50+ client. The results suggest APNs need to have consciousness raised to the need to take a sexual history with their older clients.