A survey of pediatric nephrologists on adolescent sexual health

Chronic renal disease often has an adverse effect on adolescent physiologic and psychosocial development. The severity of the disease may necessitate that the pediatric nephrologist be the adolescent's main medical provider a nd the most available physician to screen for adolescent health risk behavi ors. The purpose of this study was to determine pediatric nephrologists' pr actices of sexual history taking and diagnosis and treatment of sexually tr ansmitted infections in their adolescent patients. A survey was performed o n a convenience sample of 66 pediatric nephrologists attending an education al seminar on adolescent care at the 1997 national meeting of the American Society of Pediatric Nephrology. The outcome measures included physicians' reports of interviewing adolescents alone and screening for sexually transm itted infections. Fifty-six percent reported interviewing adolescents alone , 55% routinely ask female adolescents about sexual intercourse (53% ask ma les) and 10% routinely perform pelvic exams. Current practice in this selec ted sample of pediatric nephrologists, who by their attendance at the semin ar may represent those most motivated to do screening, still leaves adolesc ents with chronic renal disease potentially at risk for sexually transmitte d infections and pregnancy. Educational efforts should be directed at incre asing routine confidential sexual history taking for adolescents with chron ic renal disease.