[The place of sexual health in general medicine]. / Place de la santé sexuelle en médecine générale.

OBJECTIVE: Assessment of the practices and knowledge of general practitioners in Bouches-du-Rhône and Vaucluse regarding their patients's sexual health. METHOD: A descriptive cross-sectional study was conducted among general practitioners in Bouches-du-Rhône and Vaucluse from January 12, 2023 to February 9, 2023. A questionnaire was developed and sent to general practitioners practicing in Bouches-du-Rhône and Vaucluse. It was distributed by personal and professional emails and numbers, and Bouches-du-Rhône and Vaucluse's medical order. The questionnaire was divided into three parts: the first collected demographic and epidemiological data, the second assessed knowledge and practices of general practitioners regarding the sexual health, and the last evaluated practitioner's obstacles to talking about sexual health. RESULTS: Ninety-nine general practitioners responded to the questionnaire (99/276, 35.9%). In all, 30.3% obtained a rate of correct answers>60%. The general practitioners with the best response rates had training in sexology or a degree in gynecology (P=0.0109). In their practices, some topics such as contraception for adolescents, the reassessment of contraception, the search for vulvuvaginal disorders in postmenopausal patients are more addressed by doctors and in particular those of the female sex. Other topics such as sexual violence, male sexual dysfunction and sexual health in patients over 70 are less discussed in consultation. CONCLUSION: The care of sexual health is an important part of global health, specific to the profession of general practitioner. The results of our study suggest that the knowledge and practices of general practitioners in Bouches-du-Rhône and Vaucluse, are perfectible. The establishment of professional training, consultation dedicated to prevention, or even better awareness of sexual health professionals would promote a better screening.

Diagnostic value of a questionnaire for term assessment among women seeking abortion.

INTRODUCTION: Since 2020 in France, at-home medical abortion (AHMA) has been authorised for up to nine weeks of gestation. All consultations can be performed via teleconsultation. The determination of gestational age (GA) by interrogation avoids a systematic ultrasound and facilitates the care pathway. The main objective of this study was to evaluate the diagnostic value of a questionnaire to determine a GA lower than seven or nine weeks of gestation (WG). MATERIALS AND METHODS: This was a prospective study carried out on patients requesting an abortion in the Gynaecology Department of the North and Conception hospitals (Hôpital Nord and la Conception), AP-HM (Assistance Publique des Hôpitaux de Marseille), from 2 November 2021 to 1 September 2022. A modified translated questionnaire was evaluated. The questionnaire was published in June 2020 by the Royal College of Obstetricians and Gynaecologists (RCOG) to ensure access to abortion in England. All patients included in the study completed the questionnaire and received an ultrasound. We assessed the diagnostic value of the questionnaire for determining GA below seven or nine WG. RESULTS: Seven hundred and forty-eight patients were included in the study. The sensitivity of the questionnaire for determining patients with a GA of less than seven and nine WG was 84% and 93%, with a positive predictive value of 71.4% and 91.8% respectively. DISCUSSION: The study showed that the questionnaire had good diagnostic value for the selection of patients of under nine WG. Thus, women with limited access to ultrasounds could avoid them.

COVID-19 impact in abortions' practice, a regional French evaluation.

INTRODUCTION: On March 14, 2020, France has entered into stage 3 of the COVID-19 pandemic. The French National Health Agency (Haute Autorité de Santé) has urgently recommended the use of medical abortion at home between 7 and 9 weeks of gestation and telemedicine for medical abortion consultations. The main objective of this study was to assess whether the emergency measures undertaken for the management of abortions during the COVID-19 pandemic led to practice changes, and to obtain practitioners' opinions regarding the continuation of these measures. MATERIAL AND METHODS: This was a retrospective, quantitative, online self-administered survey from August 6, 2020 to October 2, 2020, aimed at health workers performing abortions (midwives, general practitioners, gynecologists obstetricians and medical gynecologists) in the South and Corse regions in France. RESULTS: Among the 124 practitioners included, 59/77 (76.6 %) offered medical abortion at home between 7 and 9 weeks of gestation and 61/89 (68.5 %) of them wished to carry on this practice. 55/123 (44.7 %) practitioners offered telemedicine for medical abortion at home and 71/115 (61.7 %) of them wished to carry on this practice. DISCUSSION: The emergency measures implemented by the the French National Health Agency (Haute Autorité de Santé) for medical abortion are approved and followed by the majority of health workers performing abortions in the South and Corse regions. This measure may be extended out of the COVID-19 epidemic.