Sexuell übertragbare Infektionen bei Frauen in der hausärztlichen Praxis – eine qualitative Interviewstudie mit Hausärzt:innen in Berlin

Up to 90% of sexually transmitted infections (STI) are asymptomatic and often diagnosed late in women, leading to serious sequelae. In the German healthcare system, there is no specifically responsible provider for sexual health counselling. Patients are also referred to general practitioners (GPs), who often feel insecure regarding this topic.

This article describes and discusses concrete GP practices in STI care for women.

Data were collected using semi-standardised guide-assisted interviews including case studies between 10/2020 and 09/2021 and analysed using qualitative content analysis. Based on a theoretical sampling approach, 13 GPs without an infectious disease focus and 6 GPs in infectiology-/human immunodeficiency virus (HIV)-focused practices were included.

Many GPs think that care is provided mainly by gynaecology. They rarely take a sexual history and focus more on the diagnosis and treatment of urinary tract infections. Some physicians, however, offer urine polymerase chain reaction (PCR) or vaginal self-smears and treatment for all STI except HIV. Options for financial remuneration and services offered by the public health authorities are rarely used, and asymptomatic patients often have to pay out-of-pocket.

Although many patients seek STI care from GPs, this is currently insufficiently covered in Germany. Sexual history and diagnostic possibilities should play a more prominent role in GP education and training in the future. A screening strategy, clear responsibilities, and referral pathways could significantly reduce the burden on patients and doctors.