Communication between adolescents and physicians about sexual behavior and risk prevention

M. A. Schuster, R. M. Bell, L. P. Petersen and D. E. Kanouse

OBJECTIVES: To assess the extent to which adolescents in a nonclinical community-based population have talked with a physician about sexual behavior and risk prevention and to examine whether adolescents value these discussions and trust physicians to protect their confidentiality. DESIGN: Self-administered anonymous survey. SETTING: Urban California school district. PARTICIPANTS: A total of 2026 students in 9th to 12th grade, 98% of the eligible students present on the survey day. OUTCOME MEASURES: Discussions with physicians about sexual matters, helpfulness of discussions, trust in physicians to protect confidentiality, and knowledge about confidentiality laws. RESULTS: Thirty-nine percent of adolescents reported discussions with physicians about how to avoid getting acquired immunodeficiency syndrome from sex, 37% about using condoms for vaginal intercourse, 13% about how to use condoms, 15% about the adolescent's sex life, 13% about how to say no to unwanted sex, and 8% about sexual orientation. In addition, 8% of adolescents had been given a condom by a physician. Adolescents were more likely to report most of these topics if they had ever had vaginal intercourse or if they had a regular physician. Most adolescents (80%-90%) would find it at least a little helpful to talk with a physician about various sexual matters. Most would trust a physician to keep secret that they asked questions about sex (75%), that they were having sex (65%), or that they were using contraception (68%). Fewer would trust physicians to keep secret a sexually transmitted disease (44%) or pregnancy (44%). For adolescents who knew that physicians in their state do not have to tell parents about sexually transmitted diseases or pregnancy, levels of trust rose, but only to 54%. CONCLUSIONS: Although professional medical organizations recommend that physicians discuss sexual matters and risk prevention with their adolescent patients, most adolescents report not having received these services. Physicians should be more aggressive about discussing these topics.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

What Schools Teach Our Patients About Sex: Content, Quality, and Influences on Sex Education
Lindau et al.
Obstet Gynecol 2008;111:256-266.
ABSTRACT | FULL TEXT  

Factors Associated With Disordered Eating Among Sexually Active Adolescent Males: Gender and Number of Sexual Partners
Ackard et al.
Psychosom. Med. 2008;70:232-238.
ABSTRACT | FULL TEXT  

Nondisclosure of Sexual Orientation to a Physician Among a Sample of Gay, Lesbian, and Bisexual Youth
Meckler et al.
Arch Pediatr Adolesc Med 2006;160:1248-1254.
ABSTRACT | FULL TEXT  

Sexually Transmitted Diseases and Managed Care: An Inquiry and Review of Issues Affecting Service Delivery
Chorba et al.
American Journal of Medical Quality 2004;19:145-156.
ABSTRACT  

Racial and Ethnic Disparities in Health Care for Adolescents: A Systematic Review of the Literature
Elster et al.
Arch Pediatr Adolesc Med 2003;157:867-874.
ABSTRACT | FULL TEXT  

Features of Sexually Transmitted Disease Services Important to African American Adolescents
Lane et al.
Arch Pediatr Adolesc Med 1999;153:829-833.
ABSTRACT | FULL TEXT  

Adolescents' Views Regarding Sexual History Taking
Rosenthal et al.
CLIN PEDIATR 1999;38:227-233.
ABSTRACT  

Preventive Services Received by Adolescents With Cystic Fibrosis and Sickle Cell Disease
Britto et al.
Arch Pediatr Adolesc Med 1999;153:27-32.
ABSTRACT | FULL TEXT  

A STD/HIV Prevention Trial Among Adolescents in Managed Care
Boekeloo et al.
Pediatrics 1999;103:107-115.
ABSTRACT | FULL TEXT  

A Computerized School-Based Health Assessment with Rapid Feedback to Improve Adolescent Health
Bracken et al.
CLIN PEDIATR 1998;37:677-683.
ABSTRACT