(605) SExual Health Identification Tool (SEXIT) Adult: Exploring Sexual Health Concerns and Violence Among Swedish Outpatients

Introduction Sexual health concerns, possible risk-taking behaviors and experiences of violence are common among outpatients and often perceived as shameful. Health care professionals (HCPs) rarely explore these concerns, mainly lacking necessary knowledge. The SEXual health Identification Tool (SEXIT) Adult is a toolkit consisting of (1) en education for HCPs, (2) a patient questionnaire that is filled out during the outpatient consultation, and (3) a handbook that guides the HCPs on follow-up questioning and possible treatment measures. SEXIT helps HCPs initate conversations on sexual health concerns, risk-taking behaviors and experiences of violence. This is the first study to the use of SEXIT Adult in a Swedish outpatient setting. Objectives The aim of this study was to explore the need for in-depth conversations on sexual health concerns, risk-taking behaviors, and experiences of violence among patients from diverse Swedish outpatient clinics using the SEXIT Adult method. Furthermore, differences concerning age, gender identity, sexual orientation and clinical setting were examined. Methods This explorative study evaluated the SEXIT Adult method through consecutive data collection using a paper questionnaire. Between November 2023 and February 2024, adult patients (≥18 years) attending ten outpatient clinics in Sweden were invited to participate. Clinics included sexual health, primary care, psychiatry, and dependency units. A total of 438 patients completed the SEXIT Adult questionnaire (26 questions) addressing sexual health, risk-taking behaviors, and experiences of violence. Sixty-one trained HCPs, including physians, psychologists, nurses, physiotherapists, social workers, rehabilitation coordinators and midwives, administered the instrument following a standardized SEXIT Adult training and handbook protocol to ensure consistent and norm-critical communication. Data were analyzed using descriptive statistics, χ2 tests, ttests, and one-way ANOVA to examine associations between possible risk or health concern responses, demographic variables, and clinic types, with statistical significance set at p<0.05. Results The preliminary results of this study show that sexual health concerns, possible risk-taking behaviors and experiences of violence were commonly reported by patients. For instance, 49.1% reported ongoing sexual problems, 58% reported experiences of sexual violence, and 37% reported experiences of physical violence. Additionally, 4.4% reported that they had committed sexual violence. Sexual minority individuals had more responses indicating risk or health concerns compared to heterosexual individuals (p<0.001). Participants aged 30-54 gave more risk or health concern responses compared to participants aged 18-29 (p=0.004) and participants aged 55-84 (p<0.001). No statstical differences in total risk or health concern responses were observed concering gender identity. Lastly, patients consulting clinics specialized in sexual health more often responded with possible risk or health concerns than patients consulting other clinics (p<.001). Conclusion Over 90% of the patients in this study gave at least two responses indicating sexual health concerns, possible risk-taking behaviors or experiences of violence. SEXIT Adult facilitates conversations on these topics, emphasizing the importance of addressing these questions in outpatient consultations, regardless of clinical setting. Sexual minority individuals report experiencing these concerns more frequently than heterosexual individuals, highlighting the need for sexual minority informed knowledge and care. Patients aged 30-54 might be a population that has been overlooked in previous research on these topics.