No Matter Where, Adolescent Sexual Health Is Everyone’s Job

Abstract

The United States should be proud of its declining teenaged pregnancy rates over the past several years, with data from 2016 revealing a continued and significant decrease in birth rates in adolescents aged 15 to 19 years from 2007 to 2016. 1 However, we still lag far behind other developed nations. 2 Moreover, adolescents and young adults still share a disproportionate burden of sexually transmitted infections (STIs) compared with other age groups. 3-5 The Centers for Disease Control and Prevention estimate that individuals aged 15 to 24 years account for one-half of all new STIs in the United States and one-quarter of new HIV diagnoses but account for only one-quarter of the population that is sexually active. 6,7 Despite this, one-third of adolescents have health maintenance examinations without any mention of sexual health. If sexual health is discussed at all, it is for an average of merely 36 seconds. 8 The American Academy of Pediatrics emphasizes the significant role that pediatricians can play in preventing these avoidable health outcomes, primarily by focusing on the pediatric office setting. 9 However, it is time for pediatric hospitalists to embrace sexual and reproductive health, including STI and HIV testing, as routine inpatient care regardless of the chief complaint or reason for admission. Currently, there is limited research in this area. In this issue of Hospital Pediatrics, 3 important articles related to sexual and reproductive health for adolescents are presented in which researchers look beyond the classic office scenario to the hospital setting. Studies have already revealed that adolescents are open to receiving contraceptive counseling in a variety of settings, such as school-based health centers, 10,11 the emergency department (ED), 12-14 and while hospitalized on the wards. 15 The researchers in these 3 Hospital Pediatrics articles contribute to the literature by providing evidence that hospitalists want to provide sexual health services, 16 that documentation of sexual history must be improved on the hospital wards, 17 and that hospitalized adolescents find HIV screening acceptable. 18