(254) SEXUAL TRAUMA IN CHILDHOOD AS A CAUSE OF SEXUAL DYSFUNCTIONS. CHARACTERIZATION OF CLINICAL CASES IN A PRIMARY HEALTH CARE SETTING IN CHILE
Authors: Gonzalez B , Povea H , Inostroza M 
Published: December 2024

Abstract

Introduction
Provision of Sexual Health services was established in 2022 as part of Primary Health Care in an urban municipal health care service in Chile. Services have been provided by a physician trained in Sexual Health following recommendations by the World Health Organization. A weekly three hours clinic was set up in each of the 6 Primary Health Care facilities and arrangements were made for people consulting in areas concerned with Sexual Health to access the Sexual Heath policlinics. This pilot experience has been successful in terms of reaching increasingly more patients and gradually has been considered an important aspect of primary health care. We are now evaluating the experience and particularly its impact on health of the population under care. Most common consultation was sexual disfunctions. In the knowledge that sexual dysfunctions might be a sequel of sexual trauma in childhood, the clinical work out included a rigorous history taking in each patient regardless the kind of sexual dysfunction patients consulted.

Objective
To enquire on the relevance of trauma in childhood in the development of sexual dysfunctions in adulthood. To provide a characterization of consultations for sexual dysfunctions in a primary care setting To enquire about the sequelae in adulthood associated to sexual trauma in childhood.

Methods
All health professionals in the primary health clinic were informed about the Sexual health clinic and general information about sexual health was provided. The consultation was long enough to complete a comprehensive clinical history, which included details about sexual intimacy. Particular care was taken to enquire about incidents in childhood and particularly all those related to trauma. Care was taken to provide a secure and safe environment during consultation which was carried out by the medical specialist in Sexual Health and an experienced female midwife, acting as a professional team. Only one of the primary health care facilities was analyzed. This was representative of the general Chilean population given its socio-economic features. Analysis of clinical notes was done anonymously by a computer-based system.

Results
After one year of setting up the sexual health clinic, 94 patients consulted, which was about 0,4% of the population covered by the facility. 25% of this consulted for sexual disfunctions and 16% consulted for dispareunia. These were 23 patients 57% of the consulting patients did not have references to sexual trauma in childhood and 43% did have a narrative of sexual trauma. These were 39 patients. This is to say that 59% of patients consulting for sexual dysfunctions, including dyspareunia, had a history of sexual trauma in infancy.

Conclusions
Sexual dysfunctions appear to be a consequence of sexual trauma in childhood in 60% of cases treated in a sexual heath care facility established as part of a primary health care setting. This may imply to consider sexual trauma incidents in childhood as part of the management of sexual dysfunctions.

Disclosure
No.