Comfort Levels of Outpatient Health Care Professionals When Asking About Substance Use–Related Sexual Activity: A Pilot Survey

Abstract

Background Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based intervention for substance use. Healthcare professionals may not receive SBIRT training, nor know of substance use’s intersection with sexual activity. This pilot survey inquired about SBIRT training history, attitudes, and comfort among outpatient healthcare professionals, including assessing sexual activity-related use. Method Snowball cross-sectional survey of outpatient healthcare professionals at a large southeastern academic medical center in June 2021 with 4-point Likert questions covering demographics, substance use attitudes, SBIRT training history, and comfort implementing SBIRT. Analysis used descriptive statistics and stratification by demographic and practice characteristics. Results Seventy-three professionals responded, of whom 82% were white and 66% were female. Forty-seven percent were age 30-39, 33% were internal medicine professionals, and 59% reported previous SBIRT training. All participants reported believing substance use is a significant health issue. Most reported they were comfortable or somewhat comfortable assessing patients for substance use (85%), dropping to 60% discussing sexual activity. Advanced practice providers and physicians identified more comfort with rapport-building around substance use than other healthcare respondents. Professionals in Infectious Diseases and Psychiatry reported greatest comfort assessing substance use with concurrent sexual activity. Conclusion There are gaps in SBIRT training and beliefs among healthcare professionals. While healthcare workers report assessing substance use is important, some professionals endorsed more comfort discussing substance use with patients than others, especially when inquiring about sexual activity. Future work could replicate the pilot to inform increasing comfort through training in the intersection of substance use and sexuality.