Sexual history taking: a dying skill?

Abstract

Background: Many adolescents are having sex and adolescents with life-limiting illnesses are no exception. It is therefore important for health care professionals to take a sexual history and provide advice about sexually transmitted diseases, unintended pregnancies, and ways of reducing high-risk sexual behaviors. Consultations should provide a forum for discussion and education. A literature review revealed no previous studies on this topic.

Objective: Our aim was to review medical consultations between adolescents with life-limiting illnesses and pediatricians to establish whether sex was discussed.

Methods: The clinical medical notes of 25 adolescents aged 12 to 18 years, under the care of a community team specializing in patients with nonmalignant life-limiting conditions at a District General Hospital in the United Kingdom (UK) were selected at random. Researchers retrospectively reviewed handwritten notes and typed letters in the medical records with a view to establishing whether a sexual history was taken on any occasion.

Results: None of the health care professionals took a sexual history from any of the adolescents on any occasion despite multiple clinic attendances.

Conclusion: Sexual health is described by the World Health Organization as a basic human right. Clinicians may struggle to accept that adolescents with life-limiting illnesses may want to talk about sex, and this study has highlighted it as a topic that is generally ignored. Health professionals should include sexual health in routine palliative assessments. Adolescents with life-limiting illnesses should not be denied the right to holistic health care.