AAP study shows the majority of doctors don’t talk about sexual health

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Parents who believe their teenagers are getting information about sexual health from their pediatricians will be surprised to find out that a new study shows that less than a third of teenagers say they talked to their doctors about sex.

The same study found that the majority of teens and parents found health care provider discussions about puberty, sexually transmitted diseases, HIV, and birth control important, according to the report published in Pediatrics.

“I was a little surprised at the huge gap between what parents and teenagers want their pediatricians to do and what actually happens,” said co-author Dr. John Santelli, Professor of Pediatrics at Columbia Vagelos College of Physicians and Surgeons at Columbia University and Professor of Population and Family Health and Pediatrics at the Mailman School of Public Health in Columbia. The good news is that “the overwhelming majority of parents want pediatricians to talk to their children about sexual health,” Santelli said.

So what’s going wrong?

Part of the problem is that medicine is currently structured in such a way that doctors don’t have much time to talk to their patients, Santelli said. But that’s not the whole answer. “I think there is a general reluctance in this society to talk about sex, contraception and even safe dating, interpersonal violence and rape,” said Santelli. “We don’t talk to young people about their feelings and relationships.”

Parents may be able to help get the ball rolling by telling the pediatrician directly that they encourage sexual health conversations with their teen, Santelli said. “Unless the doctor likes to talk about puberty and other issues, most practices have someone who would be comfortable,” said Santelli. “Or maybe you have to change doctors.”

“You don’t put a kid in a car without someone’s advice and say good luck driving,” said Santelli. “The same goes for sex.”

To investigate more closely how many pediatricians talked to their adolescent and adolescent patients about sexual health, and to understand parents ‘and adolescents’ attitudes towards such conversations, the researchers surveyed 853 parent-child pairs. The ages of the children ranged from 11 to 17 years and most identified as non-Hispanic whites (54%), while 15% were identified as non-Hispanic blacks, 2% as Hispanic American, and the remaining 7% as other racial groups. A little more than half of the children were female.

The majority of parents wanted their pediatrician to talk about a variety of sexual health topics, including:

  • Puberty: 96.7% of parents of 11-14 year olds; 95.2% of parents of 15-17 year olds.
  • STDs and HIV: 82.4% of parents of 11-14 year olds; 89% of parents of 15-17 year olds.
  • Where to Get Sexual and Reproductive Health Services: 70.6% of parents of 11-14 year olds; 76.6% of parents of 15-17 year olds.
  • Methods of birth control: 60.8% of parents of 11-14 year olds; 78.7% of parents of 15-17 year olds.
  • Safe Dating: 65.4% of parents of 11-14 year olds; 70.8% of parents of 15-17 year olds.
  • Sexual decision making: 61.9% of 11-14 year olds; 66.8% of parents of 15-17 year olds.

The numbers were lower in discussions about gender identity and sexual orientation, but a slim majority of parents of older children agreed to have pediatricians discussing these issues.

Even with such a large number of parents wanting pediatricians to speak about sexual health, only 24% of younger teens and 42.3% of older teens have ever had a provider talk to them about the issue.

“This is such an important paper,” said Dr. Elizabeth Miller, Director of Adolescent and Young Adult Health at UPMC Children’s Hospital in Pittsburgh. “The real takeaway message is that if you rely on pediatricians to have this conversation, it won’t happen.”

“The fact that so few teenagers report having one-on-one consultations with their pediatrician underscores the critical need for us to identify the barriers,” Miller said. “I wasn’t really surprised by the results, but I was shocked by the amount of work we have to do.”

“We’re all there together – parents, schools, and pediatricians – so I love it when parents come to a well with their middle school student and say they’d like to have a conversation about their child’s changing body. “Said Müller. “The parents can also encourage the doctor and child to take some time for the discussion.”

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