Young Rheum Patients Report Gaps in Sexual Health Counseling

Only Half of Teens and Young Adults on Teratogenic Medication Asked About Sexual Activity by Rheumatologists

San Diego — A recent survey reveals that only half of teens and young adults on teratogenic medication report being asked about sexual activity by their rheumatologist. Additionally, 38% of respondents were unaware that their medication could be harmful to a fetus. These findings highlight the need for improved reproductive health screenings and counseling in the field of pediatric rheumatology.

Study Details

The study, led by Dr. Brittany Huynh, a pediatric rheumatology fellow at the Indiana University School of Medicine, recruited 108 patients aged 14-23 years who were assigned female at birth and followed at pediatric rheumatology clinics affiliated with Indiana University. Participants completed a survey between October 2020 and July 2022, providing insights into their sexual reproductive health experience and knowledge. The majority of surveys were completed prior to the US Supreme Court Dobbs decision overturning Roe v. Wade.

1. 52% of participants had juvenile idiopathic arthritis, while 16% had systemic lupus erythematosus.
2. 36% of patients were on teratogenic medication, with methotrexate being the most common.
3. 76% of participants were White, with an average age of 16.7.

Findings

The survey revealed that although 82% of participants had been asked about sexual activity by a healthcare provider, only 38% reported discussing this topic with their pediatric rheumatologist. Among the 39 patients on teratogenic medication, 54% had been asked about sexual activity by their rheumatologist, and only 51% had received teratogenicity counseling.

• 85% of patients on teratogenic medication received sexual activity screenings by any provider.
• 56% of all patients received counseling on pregnancy prevention.
• 20% of patients were counseled on emergency contraception.
• Only 6% of patients discussed emergency contraception with their pediatric rheumatologist.

Furthermore, the survey highlighted gaps in knowledge regarding the health effects of rheumatic medication. Among patients on teratogens, 38% were unaware that their medication could harm a fetus if they became pregnant, while only 9% of patients not on teratogens correctly answered that their medication would not harm a fetus.

Importance of Education and Counseling

Prior studies have also shown that rheumatology patients often lack awareness of the teratogenic effects of their medications. Dr. Cuoghi Edens, a rheumatologist at the University of Chicago, emphasizes the importance of educating patients and addressing these issues during rheumatology appointments. While primary care providers may also discuss reproductive health, rheumatologists often have more frequent and consistent contact with these patients.

Dr. Huynh suggests initiating conversations about reproductive health early on and setting aside dedicated time during appointments to speak privately with adolescent patients. She also emphasizes the importance of providing easy access to emergency contraception, including writing prescriptions for interested patients. This approach helps eliminate barriers and ensures that young people have access to necessary resources.

Overall, improving reproductive health screenings and counseling in pediatric rheumatology clinics is crucial for ensuring the well-being of young patients and aligning with the Sustainable Development Goals (SDGs) related to healthcare and gender equality.

Huynh and Edens have no disclosures.

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