Review of Clinical Trials Testing the Effectiveness of Clinician Intervention Approaches to Prevent Sexually Transmitted Diseases in Adolescent Outpatients

Physicians Talking About Sex, Sexuality, and Protection With Adolescents

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.