Objective: Sexual assessment and counselling is a recommended, yet underprovided and challenging, aspect of cardiac rehabilitation. We compared the views of cardiac healthcare providers and patients in terms of their experiences of communication about sexual issues.Methods: Cardiac patients (n = 382) completed telephone surveys and hospital cardiac rehabilitation staff (n = 60) and general practitioners (n = 61) returned postal questionnaires.Results: Patients reported that sex was rarely discussed, yet nearly half of patients said they would have liked this opportunity. Most general practitioners (70%) reported not addressing sex with their patients and the majority of cardiac rehabilitators (almost 61%) reported that sexual problems were poorly addressed in their service. Patients perceived fewer barriers to communication (the main barrier was lack of privacy) than health professionals (the primary barrier for general practitioners was lack of time, and for cardiac rehabilitation staff, lack of training).Conclusion: All participants agreed that sexual assessment and counselling is currently poorly implemented. A gap exists: patients, who generally want sexual issues to be addressed, perceive fewer barriers to communication than healthcare providers, who fear causing anxiety and discomfort by raising, sexual issues with their patients.Practice implications: Developing brief interventions for healthcare providers and information materials for patients are recommended. (C) 2013 Elsevier Ireland Ltd. All rights reserved.