In other videos this therapist was very calm and reassuring, but in this clip her discomfort was palpable. I also think the conversation/information was lacking – surely the compromised immune system issue was important to address, but I think left out some important elements of a comprehensive sexual health talk. Even though this particular patient identifies as lesbian, I’m not sure that means to completely gloss over concerns that may not apply to her (like pregnancy). There could be more discussion about whether or not to go into detail about it, and give the patient the choice about whether to discuss further rather than assume she doesn’t need to. Discussion of the concept of intimacy (vs. sex), how to talk with potential partners about sexual concerns/limitations, and physical health concerns for females were also skipped. For a heterosexual patient in this same scenario, much more detail could have been provided on preventing STIs as well as pregnancy.
I may have this wrong, but I had heard from my team that sexual partners can be essentially “burned” by bodily fluids from a patient on chemotherapy (e.g., a mother whose child urinated on her leg and left something like a chemical burn, and an young man reported that his girlfriend experienced significant burning in her mouth/throat after oral sex). Is this true? If so, this would be important information to share with potentially sexually active patients.
I totally agree that the social worker seemed uncomfortable in this video and didn’t provide the patient with a truly helpful amount of detail. She also didn’t check in with the patient prior to broaching this topic to see what her concerns are, which made the conversation seem more unguided and unorganized. It would be better to give the patient a specific idea of how (and how often) STIs are transmitted between two female sexual partners – it is commonly thought that women don’t have to worry about STI transmission when just having sex with other women, so addressing that specifically and dispelling any myths would be helpful.
As for the “burning” question, I haven’t heard of chemo exposure to sexual partners being a validated risk. It seems that a lot of the evidence there is anecdotal rather than scientific and I would want to research that further before alarming patients by bringing that up as a risk.