Doctors missing opportunity to talk about sex with teens

West Lafayette, Indiana - Many physicians are missing an opportunity to listen to teens and educate them about sexual health, according to a new study in the Pediatrics journal.

"We found a third of the time that sex was not discussed during annual physicals for young teens, and when sexuality was mentioned, it was brief - discussed for less than 35 seconds during a 20-minute appointment," said Cleveland Shields, a Purdue University associate professor in the Department of Human Development and Family Studies and the study's senior author. "Sexuality and sexual development are critical topics that physicians should be addressing with teenagers. The brevity of many discussions is not enough to cover the risk of teen pregnancy, sexually transmitted infections or overall wellness."

The study, led by Stewart Alexander, an associate professor of medicine at Duke University, was published online Dec. 30. Alexander is a 1989 Purdue alumnus.

The research was funded by the National Heart, Lung, and Blood Institute, and the data was collected at 11 clinics in the Raleigh/Durham, N.C., area as part of the Duke Teen CHAT project. The analysis is based on recorded conversations between 49 physicians and 253 adolescents, ages 12-17 with the average age of 14.

None of the teenagers brought up the topic, and when it was discussed about half of the teens responded to yes-or-no questions with limited answers. Only 4 percent had prolonged conversations about sexual issues with the doctors. 

"Even if adolescents are reluctant discuss the topic, physicians initiating such conversations sends a clear message to adolescents that sexuality is an appropriate and normal discussion," Stewart said. "We know that physicians may not be comfortable with these discussions, but more resources and research is needed to improve communication strategies. If teenagers are not getting their information from trusted medical providers then where are they are learning and is that information accurate?"

The American Medical Association and the American Academy of Pediatrics both recommend that early adolescence is the time to begin discussions about sexual health.

This study also found that sexual health discussions were more likely to take place with female patients and African-American patients, and that for each year of age, adolescents were 49 percent more likely to hear from the doctor regarding sexual health.

Shields, who studies communication between physicians and patients, also received a $2.7 million grant from the National Institutes of Health to lead a five-year study on patient and physician communication to improve interactions during physician visits and empower patients to participate actively in their care.

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