Abstract
Adolescent-physician communication about sexual behaviors, sexuality, and protective
behaviors is vital for the support of sexual minorities and the prevention of sexually
transmitted infections and unintended pregnancies. The objective of this review is
to identify sexual topics that physicians and adolescents discuss during medical encounters
and examine the quantity and quality of that communication. We performed a systematic
literature review of major databases through May 2016. We identified 33 papers that
focused on adolescent-physician communication about three major sexual health topics:
coital or noncoital sexual behaviors, sexual orientation or attractions, and sexually
protective or preventative behaviors. Communication between adolescents and physicians
about these sexual topics is infrequent and coincides with calls for improvement in
clinical sex communication. Communication about sexual attractions, sexual orientation,
and noncoital sexual behaviors were the rarest in practice, whereas mentions of contraception
were more frequent. The review also highlights substantial limitations with this body
of research, and more advanced research designs are warranted. Associations between
clinical sexual communication and sexual health outcomes (e.g., contraceptive use
and sexually transmitted infection occurrence) would improve knowledge of the effectiveness
of communication in practice.
Keywords
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References
- Sexuality education for children and adolescents.Pediatrics. 2016; 138: e20161348
- Review of clinical trials testing the effectiveness of clinician intervention approaches to prevent sexually transmitted diseases in adolescent outpatients.Curr Pediatr Rev. 2005; 1: 173-185
- Provider communication about HPV vaccination: A systematic review.Hum Vaccin Immunother. 2016; 12: 1454-1468
- Will you ask? Will they tell you? Are you ready to hear and respond?: Barriers to physician-adolescent discussion about sexuality.JAMA Pediatr. 2014; 168: 111-113
- Paediatricians should do more to address male adolescent sexual health.J Paediatr Child Health. 2015; 51: 255-258
- Brief sexuality communication—a behavioural intervention to advance sexually transmitted infection/HIV prevention: A systematic review.BJOG Int J Obstet Gynaecol. 2014; 121: 92-103
- Health care information sources for adolescents: Age and gender differences on use, concerns, and needs.J Adolesc Health. 2001; 29: 170-176
- Sexuality talk during adolescent health maintenance visits.JAMA Pediatr. 2014; 168: 163-169
- Physicians use of inclusive sexual orientation language during teenage annual visits.LGBT Health. 2014; 1: 283-291
- Identifying types of sex conversations in adolescent health maintenance visits.Sex Health. 2015; (Available at:) (Accessed October 7, 2015)
- Adolescent health care experience of gay, lesbian, and bisexual young adults.J Adolesc Health. 1998; 23: 212-220
- The truth is rarely pure and never simple: A study of some factors affecting history-sharing in the GUM clinic setting.Sex Relatsh Ther. 2001; 16: 349-364
- Frequency and thoroughness of STD/HIV risk assessment by physicians in a high-risk metropolitan area.Am J Public Health. 1991; 81: 1645-1648
- Young adolescents' comfort with discussion about sexual problems with their physician.Arch Pediatr Adolesc Med. 1996; 150: 1146-1152
- Discussion of sensitive health topics with youth during primary care visits: Relationship to youth perceptions of care.J Adolesc Health. 2009; 44: 48-54
- ORIGINAL RESEARCH—EDUCATION: Impact of physician gender on sexual history taking in a multispecialty practice.J Sex Med. 2006; 3: 194-200
- A developmental approach to sexuality education: Implications for medical practice.J Adolesc Health. 1993; 14: 109-114
- Receipt of sexual health information from parents, teachers, and healthcare providers by sexually experienced U.S. adolescents.J Adolesc Health. 2013; 53: 235-240
- Pediatricians' approach to the health care of lesbian, gay, and bisexual youth.J Adolesc Health. 1998; 23: 191-193
- Anticipatory guidance regarding sex: Views of virginal female adolescents.J Adolesc Health. 1996; 19: 179-183
- Influence of physician confidentiality assurances on adolescents' willingness to disclose information and seek future health care: A randomized controlled trial.JAMA. 1997; 278: 1029-1034
- “I just think that doctors need to ask more questions”: Sexual minority and majority adolescents' experiences talking about sexuality with healthcare providers.Patient Educ Couns. 2016; 99: 1467-1472
- Providing contraceptive care to low-income, African American teens: The experience of urban community health centers.J Community Health. 2007; 32: 231-244
- Do knowledge and attitudes regarding intrauterine devices predict interest in their use?.Womens Health Issues. 2015; 25: 359-365
- Sexual history documentation in adolescent emergency department patients.Pediatrics. 2011; 128: 86-91
- Acquired immunodeficiency syndrome transmission: Changes in knowledge and behaviors among teenagers, Massachusetts statewide surveys, 1986 to 1988.Pediatrics. 1990; 85: 24-29
- Where are we on teen sex?: Delivery of reproductive health services to adolescents by family physicians.Fam Med-kans City-. 2001; 33: 376-381
- Barriers to optimal care between physicians and lesbian, gay, bisexual, transgender, and questioning adolescent patients.J Homosex. 2010; 57: 730-747
- Delivering quality care: adolescents' discussion of health risks with their providers.J Adolesc Health. 2002; 30: 190-195
- Pediatric residents' knowledge, perceptions, and attitudes towards homosexually oriented youth.Ann-r Coll PHYSICIANS Surg Can. 2002; 35: 401-405
- Factors influencing patient disclosure to physicians in birth control clinics: An application of the communication privacy management theory.Health Commun. 2011; 26: 502-511
- Nondisclosure of sexual orientation to a physician among a sample of gay, lesbian, and bisexual youth.Arch Pediatr Adolesc Med. 2006; 160: 1248-1254
- Attitudinal and contextual factors associated with discussion of sexual issues during adolescent health visits.J Adolesc Health. 2004; 35: 108-115
- Adolescents' preferences regarding human immunodeficiency virus (HIV)-related physician counseling and HIV testing.Pediatrics. 1995; 96: 52-58
- Adolescents' views regarding sexual history taking.Clin Pediatr (Phila). 1999; 38: 227-233
- Sexual and reproductive health care: adolescent and adult men's willingness to talk and preferred approach.Am J Prev Med. 2014; 47: 175-181
- Communication between adolescents and physicians about sexual behavior and risk prevention.Arch Pediatr Adolesc Med. 1996; 150: 906-913
- Confidentiality and adolescents' use of providers for health information and for pelvic examinations.Arch Pediatr Adolesc Med. 2000; 154: 885-892
- Testing for chlamydia and sexual history taking in adolescent females: Results from a statewide survey of Colorado primary care providers.Pediatrics. 2000; 106: e32
- Adolescent sexual well-being in the 21st century.J Adolesc Health. 2016; 58: 1-2
- Love matters: Romantic relationships among sexual-minority adolescents.in: Florsheim P. Adolescent romantic relations and sexual behavior: Theory, research, and practical implications. Lawrence Erlbaum, Mahwah, NJ2003: 85-107
- The sexual domain of identity: Sexual statuses of identity in relation to psychosocial sexual health.Identity. 2009; 9: 33-62
- Mom, dad, I'm straight: The coming out of gender ideologies in adolescent sexual-identity development.J Clin Child Adolesc Psychol. 2003; 32: 523-530
- Going most of the way: “Technical virginity” among American adolescents.Soc Sci Res. 2008; 37: 1200-1215
- A daily diary analysis of condom breakage and slippage during vaginal sex or anal sex among adolescent women.Sex Transm Dis. 2016; 43: 531-536
- Heterosexual anal intercourse among black and Latino adolescents and young adults: A poorly understood high-risk behavior.J Sex Res. 2013; 50: 715-722
- The cost-effectiveness of screening men who have sex with men for rectal chlamydial and gonococcal infection to prevent HIV infection.Sex Transm Dis. 2013; 40: 366-371
- Azithromycin versus Doxycycline for urogenital chlamydia trachomatis Infection.N Engl J Med. 2015; 373: 2512-2521
- Evidence for increased chlamydia case finding after the introduction of rectal screening among women attending 2 Canadian sexually transmitted infection clinics.Clin Infect Dis. 2015; 60: 398-404
- Audio-video recording of health care encounters for pediatric chronic conditions: Observational reactivity and its correlates.J Pediatr Psychol. 2015; 40: 144-153
Article info
Publication history
Published online: April 05, 2017
Accepted:
January 29,
2017
Received:
September 6,
2016
Footnotes
Conflicts of Interest: The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2017 Society for Adolescent Health and Medicine. All rights reserved.