(019) Exploring Healthcare Professional Communication to Patient About Use of Recreational Substances With Sex: Reported Frequency, Motivations, and Connection to Training

Abstract Introduction Despite little current empirical support for the use of recreational substances like alcohol, cannabis, or other recreational drugs to treat sexual dysfunction, women commonly report engaging in sex-linked substance use (SLSU). Further, women note receiving pro-substance use messages when seeking support for sexual concerns (eg, “just have a glass of wine”), including, at times, from healthcare providers. Qualitative research suggests women feel dismissed by these recommendations (Shallcross et al. 2019). However, it is unclear the frequency of these recommendations or why providers may suggest SLSU. Objective To investigate the frequency of provider-based recommendations for substance use with sexual activity, provider perceptions of patient-reported SLSU, and differences in substance use recommendations by provider type and training in sexual medicine. Methods We surveyed 92 healthcare professionals (mean age 37.13, SD = 10.58) including mental health professionals (19.6%), doctors and physician assistants (15.2%), medical students (14.1%), nurse practitioners (13.0%) gynecologists/midwives/reproductive medicine specialists (11.9%), physical therapists (10.9%), and non-medical student trainees (10.9%). Participants were recruited from international samples (86.9% US based) and were asked to complete a brief online study of healthcare professionals’ perceptions of their clients’ experiences of SLSU including report of their own or colleagues’ recommendations for SLSU, frequency of patients endorsing SLSU, patient reported motivation for SLSU, and the type of recreational substance used/recommended for SLSU. Results Patient reports of SLSU to healthcare professionals was common, with 84% of healthcare professionals indicating that patients had reported trying or using recreational substances with sexual activity. Of those, 39% stated a patient reports SLSU to them monthly, 20% weekly, and 4% daily. Further, 41% of healthcare professionals stated they themselves or a provider they know has recommended their patients engage in SLSU. The most reported motive healthcare professionals stated for making this recommendation was that it “helps patients relax” (36.8%) followed by “providers are not sure what else to recommend” (18.4%) and “it’s more accessible than other types of treatments” (11.4%). Beliefs that recreational substances increase sexual pleasure (8.8%) or effectively reduce sexual dysfunction (8.8%) were low. Cannabis was the most recommended substance by healthcare professionals while alcohol was the most common substance reported by patients. Lastly, healthcare professionals with more training on treating sexual distress were significantly more likely to recommend SLSU or know someone who had, (t(61.27) = –2.95, p = 0.01) but recommendations did not differ significantly by professional type (p 0.05). Conclusions Our results indicate that over 40% of healthcare professional report recommending, or knowing a fellow provider who recommended, that patients engage in recreational substance use to manage sexual concerns. This recommendation was more likely to be reported by providers with more training in treating sexual dysfunction. Given that patients report these recommendations can feel dismissive if conducted without context, our findings support more provider training in how to conduct more detailed discussion of our patients use of substances with sexual activity and understanding motivations behind SLSU. Disclosure No.