CHLAMYDIA-TRACHOMATIS GENITAL-INFECTION NOVA-SCOTIA PHYSICIANS APPROACHES

OBJECTIVES To determine family physicians' approaches to detecting, ma naging, and preventing genital Chlamydia trachomatis infection and the ir perceptions of barriers to prevention. To determine whether sex of physician is associated with differences in clinical approach to chlam ydia, with levels of effort aimed at its prevention, and with perceive d barriers to preventive efforts. DESIGN Questionnaires were sent to a random sample of family physicians. SETTING All health regions in Nov a Scotia. PARTICIPANTS Two hundred fifty-seven Nova Scotia family phys icians. MAIN OUTCOME MEASURES Responses to survey questions analyzed f or association of practice behaviours with sex of physician. RESULTS R esponse rate was 60%. Most physicians performed diagnostic tests for c hlamydia on all patients. Responses indicated that 17% would test for C trachomatis during an annual Papanicolaou test in a low-risk 30-year -old, 61% would test a high-risk 81-year-old man, and 89% would test a pregnant 17-year-old. Therapies physicians might use were judged appr opriate in 96% of responses. Only 51% indicated they would:ever discus s false-positive test results with patients. Men physicians were less likely than women to ask 75% or more of their adolescent patients abou t sexual activity or to educate them about prevention of sexually tran smitted diseases, Women physicians saw time and the fee schedule as le ss serious barriers to prevention than men did. CONCLUSIONS Some physi cians are not managing C trachomatis well. We should explore situation s where gaps in performance are associated with sex of physician.