Sexual and Reproductive Health Discussions During Preventive Visits

Abstract

OBJECTIVES: To quantify adolescent-and parent-perceived importance of provider-adolescent discussions about sexual and reproductive health (SRH), describe prevalence of provider confidentiality practices and provider-adolescent discussions about SRH topics during preventive visits, and identify missed opportunities for such conversations. METHODS:We used data from a national Internet survey of 11-to 17-year-old adolescents and their parents. Data were weighted to represent the noninstitutionalized US adolescent population. Adolescents who had a preventive visit in the past 2 years and their parents reported on perceived importance of provider-adolescent discussions about SRH topics: puberty, safe dating, gender identity, sexual orientation, sexual decision-making, sexually transmitted infections and HIV, methods of birth control, and where to get SRH services. Adolescents and parents reported whether they had ever discussed confidentiality with the adolescent's provider. Adolescents reported experiences at their most recent preventive visit, including whether a provider spoke about specific SRH topics and whether they had time alone with a provider.RESULTS: A majority of adolescents and parents deemed provider-adolescent discussions about puberty, sexually transmitted infections and HIV, and birth control as important. However, fewer than one-third of adolescents reported discussions about SRH topics other than puberty at their most recent preventive visit. These discussions were particularly uncommon among younger adolescents. Within age groups, discussions about several topics varied by sex.CONCLUSIONS: Although most parents and adolescents value provider-adolescent discussions of selected SRH topics, these discussions do not occur routinely during preventive visits. Preventive visits represent a missed opportunity for adolescents to receive screening, education, and guidance related to SRH.

Factors influencing the conduction of confidential conversations with adolescents in the emergency department: A multicenter, qualitative analysis

“…10 The discussion of sensitive topics is also limited, with few adolescents admitting to discussing sexual and reproductive health topics other than puberty at their most recent preventive visit. 11 Issues related to confidentiality are particularly relevant in emergency departments (EDs). Prior studies suggest that ED HCPs often forego confidential conversations about sensitive topics, even when they perceive them potentially necessary for their patient's clinical care.…”

Ask me, listen to me, treat me well and I shall tell: a qualitative study of Swedish youths’ experiences of systematic assessment of sexual health and risk-taking (SEXIT)

“…13 International studies have concluded that adolescents would like healthcare providers to address sexuality issues, and that they prefer to discuss sensitive topics directly. 4,14,15 However, young people's experiences of being asked about sexual risk-taking and sexual ill health, in a context of systematic assessment within health care, have not, to our knowledge, been previously investigated. The aim of this study was therefore to explore youth clinic visitors' experiences of systematic assessment of sexual ill health and risk-taking using SEXIT, and specifically of filling out the SEXIT questionnaire.…”

Opportunities to Improve Adolescent Health and Wellbeing Through Medical Education and Delivery of Quality Preventive Care

“…In previous work, we have explored a triadic model, recognizing the complex relationship between parents, adolescent patients, and clinicians [5]. Parents select how and where most adolescents get routine healthcare, and this model reflects the partnership parents expect with pediatricians, family physicians, or other clinicians caring for their teens.…”