Let’s talk about sex . . . or not

Kari Schneider, MD

Doctors don’t talk enough to their young patients about sex, and neither do parents-but parents also aren’t sure that it’s a clinician’s place to have “the talk” with their children, according to a new study.

“Let’s talk about sex: Do adolescents’ parents and primary care physicians talk to them about sex?” was presented as an abstract at the Pediatric Academic Societies (PAS) 2018 meeting in Toronto in May 2018 by Brinda Desai. Co-author Kari Schneider, MD, an assistant professor in the Department of Pediatrics at the University of Minnesota, Minneapolis, says the research project demonstrates the need to increase attention on why these conversations aren’t happening more and what can be done.

The goal of the study was to assess the frequency at which teenagers and young adults were asked about their sexual activity and screened for sexually transmitted infections (STIs). Researchers polled 582 adolescents aged 13 to 17 years and 516 parents who attended the Minnesota State Fair in 2017 for the report.

Adolescents and young adults have more STIs than all other ages combined, Schneider says, and parents and clinicians have to address the risks and discuss safe sex practices with them.

However, the study found that nearly half of all teenagers-45%-say they have not been asked regularly about sex by their primary care providers (PCPs). Only 13% say their doctor offered them screening for STIs. On top of not being asked about sex by their doctors, just 39% of teenagers reported talking about sex with their parents, despite the fact that 90% of parents reported having “the talk” with their children.

The study also found that older teenagers were asked about sex and STIs more frequently than younger teenagers, and white female patients were more likely to encounter these assessments than minority females and males.

When discussions with clinicians did occur, 49% of parents stated that it happened with their knowledge, while 24% were unaware that the conversation had taken place. In regard to parent communications, mothers or female caregivers were most often the ones to address sex with their teenagers.

It was unclear from this study whether adolescents felt comfortable discussing sex with their doctors, although the study did address the comfort level of parents in regard to this line of questioning.

A quarter of the parents polled felt that PCPs should not be discussing sex with teenagers and young adults, according to the researchers.

“We were truly astonished to find such a large percentage felt that pediatricians should not be discussing sex with their children,” Schneider adds.

Addressing parental concerns about sex-related discussions conducted by clinicians is an important next step in addressing this problem, Schneider adds.

“Having everyone involved-parents, adolescents, and providers-on the same page that these discussions, done in a confidential way, are imperative to comprehensive preventive care of adolescent patients should be the ultimate goal,” she adds.

Schneider says she hopes the study will prompt clinicians to reflect on their own discussions with patients.

“I am hopeful that pediatricians will note that a low percentage of adolescents feel that they are being asked about sex at primary care visits,” Schneider says. “Perhaps they are being asked but just not in a way that is meaningful or memorable to the adolescent.”

Only the abstract for the study was presented at the meeting, according to Schneider. The complete findings of the study have yet to be published.