Talking about sexual health in medical appointments and association with the doctor-patient relationship: adolescents' perceptions

Abstract

-Background: Discussing sexual health is essential for a comprehensive adolescent medical assessment and to support adolescents' informed and safe decisions, yet it remains a challenge for both teenagers and health professionals. Effective doctor-patient communication might provide the necessary support for adolescents to talk about this sensitive topic. The aim of this study was to understand adolescents' perspectives on discussing sexual health during medical appointments and the association with the doctor's communication skills. -Methods: Students under 20 years old in the 10th, 11th, and 12th grades of high school at two different institutions completed an online questionnaire that included the Communication Assessment Tool (CAT) for assessment of physicians' communication skills. Data was analyzed with parametric and non-parametric tests. -Results: Among the 1082 participants (mean number of doctors' appointments=2.45; SD=1.47), nearly all students considered it appropriate and important to discuss sexual health with the doctor, yet 50.6% have never done it. About 42.9% reported feeling uncomfortable discussing sexual health due to shame, fear of judgment, and concerns about confidentiality. Students who considered it appropriate or important to talk about this sensitive topic in medical appointments gave significantly higher scores to the doctor's communication (p = 0.012; p = 0.001, respectively). Students who had a higher number of consults gave higher scores to their doctor's communication skills (p< 0.001). Doctors who talked about sexual health received higher communication scores from students compared to those who did not address the topic (p< 0.001). Adolescents who felt comfortable discussing their sexual health with their doctor rated the doctor's communication skills significantly higher than those who did not feel comfortable (p< 0.001). -Conclusion: Communication is the central skill in medicine, and it is also the basis of a trustful and positive doctor-patient relationship. This study shows that adolescents think it's important and appropriate to talk about sexual health in medical appointments. Their perceptions of the doctor's interpersonal communication skills are significantly associated with their willingness to discuss their sexual health and sexual life with the doctor.