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

Study objective: Medically 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.

Methods: Subspecialist 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.

Results: Less 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%).

Conclusion: Despite 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.