Patient–Provider Communication About Sexual Health Among Unmarried Middle-aged and Older Women

  • Mary C. Politi
  • Melissa A. Clark
  • Gene Armstrong
  • Kelly A. McGarry
  • Christopher N. Sciamanna
Original Article

DOI: 10.1007/s11606-009-0930-z

Cite this article as:
Politi, M.C., Clark, M.A., Armstrong, G. et al. J GEN INTERN MED (2009) 24: 511. doi:10.1007/s11606-009-0930-z



Although past studies have highlighted the importance of patient–provider communication about sexual health and intimate relationships (SHIR), much of the research has focused on young women’s or married women’s experiences when discussing SHIR with their providers.


To describe experiences of unmarried, middle-aged and older women in communicating about SHIR with their health care providers.


Qualitative interviews were conducted with 40 unmarried women aged 40–75 years. We compared the responses of 19 sexual minority (lesbian and bisexual) women and 21 heterosexual women.


Women varied in their definitions of intimate relationships. Not all women thought providers should ask about SHIR unless questions were directly related to a health problem, and most were not satisfied with questions about SHIR on medical intake forms. However, the themes women considered to be important in communication about SHIR were remarkably consistent across subgroups (e.g. previously married or never married; sexual minority or heterosexual). Sexual minority women were more hesitant to share information about SHIR because they had had prior negative experiences when disclosing their sexual orientation or perceived that clinicians were not informed about relevant issues.


Some women felt that providers should ask about SHIR only if questions relate to an associated health problem (e.g. sexually transmitted infection). When providers do ask questions about SHIR, they should do so in ways that can be answered by all women regardless of partnering status, and follow questions with non-judgmental discussions.


communication skillsdoctor-patient relationshipwomen’s health

Copyright information

© Society of General Internal Medicine 2009

Authors and Affiliations

  • Mary C. Politi
    • 1
  • Melissa A. Clark
    • 2
  • Gene Armstrong
    • 2
  • Kelly A. McGarry
    • 3
  • Christopher N. Sciamanna
    • 4
  1. 1.Centers for Behavioral and Preventive Medicine, The Miriam HospitalBrown Medical SchoolProvidenceUSA
  2. 2.Department of Community Health and Center for Gerontology and Health Care ResearchBrown UniversityProvidenceUSA
  3. 3.Division of General Internal MedicineBrown Medical School and Rhode Island HospitalProvidenceUSA
  4. 4.Division of General Internal Medicine and Public Health SciencesPenn State College of MedicineHersheyUSA