Correlates of Sexual and Reproductive Health Discussions During Preventive Visits: Findings From a National Sample of US Adolescents

Purpose: This study examines characteristics of healthcare delivery, providers, and adolescents associated with provider-adolescent discussions about sexual and reproductive health (SRH) during preventive visits. Methods: Data were from a 2019 national internet survey of U.S. adolescents ages 11-17 years and their parents. Adolescents who had a preventive visit in the past 2 years (n = 853) were asked whether their provider discussed each of eight SRH topics at that visit: puberty, safe dating, gender identity, sexual orientation, whether or not to have sex, sexually transmitted infections including human immunodeficiency virus, birth control methods, and where to get SRH services. Eight multivariable logistic regression models were examined (one for each SRH topic as the outcome), with each model including modifiable healthcare delivery and provider characteristics, adolescent beliefs, behaviors, and demographic characteristics as potential correlates. Results: Provider-adolescent discussions about SRH topics at the last preventive visit were posi-tively associated with face-to-face screening about sexual activity for all eight topics (range of adjusted odds ratios [AORs] = 3.40-9.61), having time alone with the adolescent during that visit (seven topics; AORs = 1.87-3.87), and ever having communicated about confidentiality with ad-olescents (two topics; AORs = 1.88-2.19) and with parents (one topic; AOR = 2.73). Adolescents' perception that a topic was important to discuss with their provider was associated with provider-adolescent discussions about seven topics (AORs = 2.34-5.46). Conclusions: Findings that provider-adolescent discussions about SRH during preventive visits were associated with modifiable practices including time alone between providers and adolescents and screening about sexual activity can inform efforts to improve the delivery of adolescent SRH services within primary care. (c) 2021 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Automated summary

This study examines the characteristics of healthcare delivery, providers, and adolescents that are associated with provider-adolescent discussions about sexual and reproductive health (SRH) during preventive visits. The study finds that such discussions are positively associated with face-to-face screening about sexual activity, having time alone with the adolescent, and communicating about confidentiality. The perception of adolescents regarding the importance of a topic is also closely related to the discussions.