Brett Smith for redOrbit.com – Your Universe Online
Just like a visit to the doctor, a frank and honest conversation about sexual health can be uncomfortable at times. The American Academy of Pediatrics (AAP) now recommends that physicians take more time in their annual check-ups with teens to discuss sexual issues. However, less than two thirds of doctors and teenage patients actually have this conversation and when they do it typically lasts less than one minute – according to a study published on Monday in the journal JAMA Pediatrics.
“It’s hard for physicians to treat adolescents and help them make healthy choices about sex if they don’t have these conversations,” said study author Stewart Alexander, an associate professor of medicine at Duke University. “For teens who are trying to understand sex and sexuality, not talking about sex could have huge implications.”
The AAP suggests that annual check-ups are key opportunities to discuss sexual development, sexually transmitted infections and unwanted pregnancy prevention – in addition to other health issues such as such as smoking and drinking alcohol.
Study researchers collected information by surveying teens or physicians after annual visits. The team also made audio recordings of the naturally occurring conversations that took place during annual visits or physicals for over 250 adolescents, ages 12 to 17.
The study team found that physicians broached the issue of sex 65 percent of the time, with an average conversation length of 36 seconds. All of these sexual health conversations were initiated by the physicians. “We saw that physicians spent an average of 22.4 minutes in the exam room with their patients. Even when discussions about sex occurred, less than 3 percent of the visit was devoted to topics related to sex,” Alexander said. “This limited exchange is likely inadequate to meet the sexual health [and pregnancy/STD] prevention needs of teens.”
The researchers found that, perhaps unsurprisingly, the teens were extremely reluctant to discuss sex. When the doctors brought up the topic, about half of the teens simply responded to yes or no questions with limited discussion, and 4 percent of teens had extended discussion with their physicians. The team also found that female adolescents were more than twice as likely to discuss sexual issues than male teens.
“The implication for males is troublesome because as they get older, they become less likely to routinely see physicians outside of checkups or sports physicals,” Alexander said. “Thus, the annual visits become essential and are perhaps the only opportunity for physicians to address the sexual behaviors of adolescent boys.”
When males in the study did discuss sexual issues, they were more likely to be older teens. Current guidelines recommend that doctors start these conversations in early adolescence before teens are sexually active.
“There’s a saying that it’s always better to have the conversation two years too soon than one day too late,” Alexander said. “If you’re one day too late, the teens may already be engaging in sexual behaviors that have consequences for them.”
“Although adolescents have access to information on sex from a variety of sources, physicians could do more in support of teens’ healthy sexual development,” he added. “Initiating conversations demonstrates to adolescents that talking about sex is a normal part of a checkup, and may open the door for more extensive discussions.”