It is understandable that some teenagers may find it difficult to talk to their doctors about sexual health. But new research suggests that around one-third of adolescents who have annual visits with their physicians do not have conversations about sex or sexuality issues, and that physicians should provide more education and counseling in this area.

This is according to a new study published in the journal JAMA Pediatrics.

According to the Centers for Disease Control and Prevention (CDC), there are approximately 20 million new cases of sexually transmitted infections (STIs) in the US every year, with around 50% of these cases occurring among young men and women.

The researchers, led by Stewart C. Alexander of the Duke University Medical Center in North Carolina, say that physicians can play an important part in promoting healthy sexuality in adolescent patients by discussing STIs and pregnancy prevention, as well as providing education and counseling on such issues.

To find out how much time physicians and adolescent patients spend discussing sex and sexuality issues, the investigators analyzed 253 adolescents and 49 physicians over 11 clinics in North Carolina.

By recording discussions between patients and their physicians during medical visits, the researchers analyzed the amount of time spent discussing sex and sexuality issues, the level of adolescent participation in these talks and physician and patient characteristics that were linked to sexuality discussions.

The investigators say they defined sexuality talk as any discussion, comment or question linked to sexual activity, sexuality, dating or sexual identity.

From the analysis, it was revealed that around 65% of all medical visits involved some kind of discussion of sexual context. Of these visits, 30% of sexuality discussions lasted between 1 and 35 seconds, while 35% lasted 36 seconds or longer.

Sexual discussions occurred more with female patients, older adolescents and and African-American adolescents. These discussions were also more common when conversations were explicitly confidential and when the medical visits were of a longer duration.

Furthermore, it was found that in all discussions, the physician was the first to initiate the subject of sexuality issues. However, physicians failed to attempt to engage the patients in any of the discussions.

The investigators say this suggests that physicians must be “proactive in addressing sexuality issues with adolescents and cannot assume that adolescents will initiate discussions if topics are sufficiently important.”

They add:

Even if adolescents are reluctant to engage in sexuality talk, physicians initiating such conversations sends a clear message to adolescents that sexuality is an appropriate and normal discussion topic at health maintenance visits, which may open the door for more extensive and detailed discussions during future visits.”

Overall, they conclude that the study findings suggests that physicians are “missing opportunities” to talk to patients about healthy sexual behaviors, and to counsel and educate them on preventing the occurrence of STIs and unplanned pregnancies.

Medical News Today recently reported on a study suggesting that a disconnect between patients and doctors could impact weight loss interventions.