Sexual Activity Screening and Referral to Gynecology Services among Adolescent Women with Chronic Disease in the Pediatric Subspecialty Setting

Abstract

Study ObjectiveMedically complex adolescent girls have significantly increased risk of disease exacerbation from pregnancy, and their use of teratogenic medications poses a risk to a developing fetus. Pediatric subspecialists have an opportunity to screen for sexual activity and refer to gynecology if indicated. MethodsSubspecialist pediatricians (n = 39) completed a survey of their screening and referral practices. A retrospective chart review of a proportion of visits by these providers in the previous 6 months (n = 222) was conducted to compare documented sexual activity, contraception counseling, and referral practices with self-report data. ResultsLess than half of providers reported routinely asking about sexual activity (46%), whereas 69% reported routinely referring sexually active adolescents to gynecology. Documentation indicated 11 instances of sexual activity screening (4.9%) and 7 referrals (2.7%). ConclusionDespite frequent contact with the medical field and use of teratogenic medications, medically complex adolescent girls are inconsistently screened for sexual activity and are rarely referred to gynecology.