title: Sexually transmitted infection screening and reproductive health counseling in adolescent renal transplant recipients: Perceptions and practice patterns. A study from the Midwest Pediatric Nephrology Consortium.
abstract: We wanted to identify practice patterns and perceived barriers among pediatric nephrologists regarding STI screening and reproductive health counseling in adolescent renal transplant recipients. We created an online Likert-scaled survey. Response rate was 54%. The majority (83%) believed STI risk in their patients was similar to or higher than healthy teens. Interestingly, while 67% felt moderately or very confident in asking about sexual activity and counseling about safer sex, only 43% routinely or always inquired about sexual activity, and only 42% routinely or always counseled about safer sex. Fifty-four percent routinely or always discussed contraceptive options and implications of unintentional pregnancy. Fifty-one percent routinely or always referred patients to a gynecologist or adolescent provider for contraception prescription. The most common counseling mechanism was informal discussions in clinic (87%). Ten percent had no mechanism in place. Major barriers included time limitations, adolescents' fear regarding confidentiality, and lack of professional training. This is the first report of perceptions and practice patterns of pediatric nephrologists regarding STI screening and reproductive health counseling. Providers seem to recognize the importance of counseling; however, translation into practice remains low. Professional training in this area and increased encounter time could improve counseling delivery and thereby reduce risk in this population.
authors.affiliation: Nephrology, Children's Hospital of New Orleans, New Orleans, LA, USA.
authors.forename: Isa F
authors.initials: IF
authors.lastname: Ashoor
authors.affiliation: Washington University & St. Louis Children's Hospital, St. Louis, MO, USA.
authors.forename: Vikas R
authors.initials: VR
authors.lastname: Dharnidharka
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D003376:Counseling; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D015146:Midwestern United States; D009398:Nephrology; D010372:Pediatrics; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D034121:Reproductive Health Services; D021841:Safe Sex; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000517:prevention & control; D047568:Unsafe Sex / Q000517:prevention & control
keywords: contraception; counseling; kidney transplantation; patient education; pediatric; psychosocial; sexuality