The onset of adolescence also means the need to discuss a variety of sexual health topics, such as sexually transmitted infections (STIs), pregnancy, and contraceptives. During a session at the virtual 2021 American Academy of Pediatrics National Conference & Exhibition, Maria Trent, MD, MPH, FAAP, FSAHM, chief of the division of medicine for adolescents and young adults at Johns Hopkins School of Medicine and Public Health in Baltimore, Maryland , discussed the importance of discussing sexual health with teens, how the pandemic has changed the landscape and what telehealth can bring to the plate.
For teens, developing healthy sexuality is an important milestone on the road to adulthood. Parents are an important part of this and should be part of the conversation. Research has shown that high-quality discussions between parent and teen about sexual health can lead to delays in the first sexual experience; making the teen more likely to discuss STDs and pregnancy with partners; use contraceptives; and used condoms during his or her last sexual experience. Such discussions are becoming more common, but both parents and teens express feelings of unease and many adolescents feel ashamed to discuss the topic with their parents. Many parents and teens rely on their pediatrician to have conversations and most visits do have some form of sexual health content, but the average time spent is 36 seconds and only half of teens are given the time to interact with their provider alone. to talk.
The COVID-19 pandemic sparked another wrinkle. Social distancing may have been an important way to prevent the spread of the disease, but information indicates that many teens and young adults still engage in sexual activity. Many medical offices were closed for personal visits in the early months, and public health departments that would have worked with sexual health were often moved to conduct COVID-19 testing. Reduced access to care introduced new barriers to access to contraceptives; preventive visits, reducing the likelihood of anticipatory counseling; providing pregnancy options and counseling; advice on risk reduction; and STI/HIV screening and treatment.
Telehealth is an important way to provide vital sexual health care to adolescents. Some of the key areas of care that can be provided through this include anticipatory counseling, birth control counseling, family planning, aftercare coordination, and connecting teens with other resources. It also offers clinicians and teens the chance to have a private and confidential conversation on a variety of sexual health topics. When visiting an adolescent patient in the office, clinicians should tell them that telehealth is an option to discuss topics of a sexual nature. On a telehealth visit, health professionals must ensure that the “tone” of the visit is the same as in the office. Due to the sensitive nature of the topics discussed, clinicians must take several steps to ensure that adolescent patient confidentiality is maintained:
Inform the patient what confidentiality means and the limits that can be placed on that confidentiality Be aware of who is in the room with the patient Help the teen find a space that is as private as possible, which may require some creativity Encourage the teen recommend to use headphones during the visit
During telehealth visits, clinicians should discuss sexual health with all patients, not just female patients. Motivational interviewing can be a good way to encourage proactive and protective behavior. If a hybrid visit requires the patient to come to the office for other elements, such as testing, clinicians should provide support as needed and ensure that the patient can come to the office for that purpose.
1. Trent M. Meeting Teens Where They Are: Using Telemedicine to Improve Sexual Health. American Academy of Pediatrics 2021 National Conference and Exhibition; virtual. Access until October 11, 2021.