Discussing Sexual Health During Diabetes Care, a Survey of UK Women—My Diabetes Nurse “Would Fall off Her Chair If I Mentioned It”

TL;DR

UK women with diabetes rarely discuss sexual health with healthcare professionals, facing barriers like fear of negative reactions and unmet educational needs.

Contribution

This study identifies communication barriers and expectations of UK women regarding sexual health discussions during diabetes care.

Findings

Only 27% of participants had ever discussed sexual health with healthcare professionals during diabetes care.

Many women expected healthcare professionals to find the topic inappropriate or annoying.

Participants expressed a preference for female healthcare professionals for such discussions.

Abstract

Aims: To ask UK women with diabetes whether they have discussed sexual health with healthcare professionals (HCPs) during diabetes care, and to explore communication barriers. Methods: An online questionnaire was developed, based on a published HCP communication survey, piloted by six women with diabetes. A total of 163 participants, recruited via social media and HCP network, completed Part 1 by selecting Likert or narrative response options, providing descriptive data. We report proportions with 95% confidence intervals (Wilson); percentages are calculated using the number responding to each item. Item-level missingness is retained as a non-analysed category, and the n is reported per question. No inferential comparisons were planned a priori. After Part 1 completion, participants could choose to finish, or to continue to Part 2 questions regarding vulval anatomy, function, and vocabulary (77 completed 2A: 80 completed 2B). Part 2 data was analysed thematically. Results: During diabetes care, a minority of participants, 44/163 (27%), said they had ever discussed sexual health, or had been advised how to access sexual health support, 28/163 (17%). If an HCP discussed sexual health, many women said they expected to feel surprised, 114/163 (70%), or pleased, 88/163 (54%). Some participants said they expected HCPs would find the topic inappropriate, 56/163 (36%), or annoying, 44/163 (27%). Some participants expressed HCP gender preference (75/163 [46%] female and 4/163 [3%] male) for such discussion. Part 2 findings revealed unmet sexual health literacy needs with potential to impact on communication with HCPs. Conclusions: Women reported infrequent communication about sexual health and diabetes during diabetes care. Findings highlight potential communication barriers for some participants including the following: unmet educational needs regarding diabetes and sexual health, lack of confidence about available support, fear of a negative HCP response, and preference for the gender of the HCP. Whereas in previous research, HCPs feared upsetting women by discussing sexual health, many participants said they expected to respond positively.

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