A substantial share of German healthcare professionals reported inadequate training regarding sexual health problems in general and sex workers' health issues specifically, with results indicating 'that sexual health issues and sex workers' specific healthcare requirements are not sufficiently addressed in the curricula of German healthcare professionals.'
Key Findings
Results
A substantial share of German healthcare professionals and medical students reported experiencing inadequate training regarding sexual health problems in general.
Survey included 130 physicians, 63 psychotherapists, and 154 medical students (total N=347)
The study was a nationwide, cross-sectional online survey
Respondents reported on their perceived quality of training regarding sexual health problems across all patients
The finding applied across all three professional groups surveyed
Results
A substantial share of respondents reported inadequate training specifically regarding healthcare issues of sex workers.
Respondents assessed their training quality specifically concerning sex workers' health issues
This was assessed separately from general sexual health training
The survey covered both discrimination-related concerns and sexually transmitted disease management relevant to sex workers
The finding was consistent across physicians, psychotherapists, and medical students
Results
Most respondents reported feeling relatively comfortable when dealing with sexual health topics and sex worker patients despite reporting inadequate training.
This finding applied to both general sexual health problems and sex worker-specific issues
The result was described as 'most respondents reported feeling rather comfortable when dealing with these topics'
This comfort level existed even among those who reported inadequate training
The finding was notable given the gap between self-reported training quality and reported comfort levels
Results
There was a positive correlation between feeling comfortable when treating sexual health problems or sex workers and perceived quality of training on these topics.
Higher perceived training quality was associated with greater comfort when treating patients with sexual health problems
The same positive correlation was found specifically for comfort treating sex workers
This correlation suggests that improving training could increase healthcare professionals' comfort with these patient populations
The correlation was identified across the combined sample of physicians, psychotherapists, and medical students
Conclusions
Sexual health issues and sex workers' specific healthcare requirements are not sufficiently addressed in the curricula of German healthcare professionals.
This conclusion applied to medical education curricula as well as psychotherapy training programs
Sex workers face higher risk for both discrimination and various sexually transmitted diseases, making specialized training particularly important
The authors called for future adaptations of curricula to address these gaps
The gap was identified through self-report of perceived training quality rather than objective curriculum analysis
Background
Sex workers represent a patient population with elevated healthcare needs due to higher risk for discrimination and sexually transmitted infections.
Sex workers were identified as potentially requiring 'more specialized care than others'
Two specific risk areas were identified: discrimination and various sexually transmitted diseases
Little was known prior to this study about the quality of healthcare professionals' training regarding sex workers' health in Germany
This framing provided the rationale for studying this specific subgroup within sexual health training
What This Means
This research surveyed 347 German healthcare professionals and medical students — including 130 physicians, 63 psychotherapists, and 154 medical students — about how well they felt their training had prepared them to handle sexual health issues and to care for sex worker patients. The study found that a substantial portion of respondents felt their training on both general sexual health and the specific needs of sex workers was inadequate. Interestingly, despite reporting insufficient training, most participants said they felt fairly comfortable dealing with these topics in practice.
The study also found that professionals who felt better trained tended to feel more comfortable treating patients with sexual health problems and sex worker patients specifically, suggesting that improved education could translate into better patient care. Sex workers face unique healthcare challenges, including higher risks of sexually transmitted infections and discrimination in healthcare settings, making it especially important that providers are well-prepared to serve this population.
This research suggests that German medical and psychotherapy training programs may need to update their curricula to better address sexual health topics and the specific healthcare needs of sex workers. Closing this training gap could help healthcare professionals feel more confident and provide more effective, non-discriminatory care to a vulnerable patient population.
Reinehr S, Neuendorff N, van der Veen R, Langenbach B, Thieme A. (2024). Training needs of German healthcare professionals regarding sexual health and sex workers: results of a nationwide, cross-sectional survey.. BMC medical education. https://doi.org/10.1186/s12909-024-06551-3