Primary Care Physicians' Knowledge of, Attitudes Towards, and Practices in Sexual Healthcare for Patients of Middle and Old Age in Trinidad & Tobago

Background: Our understanding of Primary Care Physicians’ (PCPs) knowledge about sex in later life, attitudes towards addressing sexual health concerns and sexual history, and taking practices with patients in middle and old age is lacking. This thesis is a mixed-methods study that examines PCPs’ knowledge, attitudes, and sexual health care practices with patients who are in the middle and old age in Trinidad and Tobago. It offers PCP’s accounts of what shapes their attitudes about sexuality in later life and provides details regarding PCPs’ characteristics associated with their existing knowledge, attitudes, and influences on their current sexual health care practices. Method: A 2-pronged sequential mixed-method (qualitative & quantitative) approach followed by methodological triangulation had been employed. Results: The findings of this thesis are presented in the form of four (4) research papers: Paper 1: Rabathaly PA, Chattu VK. Emphasizing the importance of sexual healthcare among middle and old age groups: A high time to re‑think. Journal of Natural Science, Biology & Medicine, 2018. DOI: 10.4103/jnsbm.JNSBM_128_18; Paper 2: Rabathaly PA, Chattu V. An exploratory study to assess Primary care physicians’ attitudes towards talking about sexual health with older patients in Trinidad and Tobago. Journal of Family Medicine and Primary Care 2019. DOI: 10.4103/jfmpc.jfmpc_325_18; Paper 3: Rabathaly PA, Chattu V. Sexual Healthcare Knowledge, Attitudes and Practices amongst primary care physicians in Trinidad and Tobago. Journal of Family Medicine and Primary Care 2019. DOI: 10.4103/jfmpc.jfmpc_322_18; and Paper 4: Rabathaly PA, Chattu V, (2019). What primary care physician characteristics are associated with the sexual health care management of middle aged and older patients and how different clinical scenarios influence these? [Accepted]. Conclusion: PCPs in Trinidad and Tobago have an evasive attitude regarding sexuality and sexual health care for middle-aged and older patients. They have inferred a low level of knowledge about sexual health in later life, and they have an inconsistent diagnostic sexual history taking practices with them. Findings underscore the need for improved PCP sexual health care medical education and communication training in sexual history and taking and revising sexual healthcare policies to accommodate both middle-aged and older patients.