Sexual health communication between Asian-American adolescents and health-care providers

Health care providers play an important role in providing accurate information to adolescents about sexual health issues, including prevention of pregnancy and sexually transmitted infections (STIs). There has been limited research, however, on how to best provide effective discussions about sexual health with Asian-American adolescents in a culturally sensitive manner.

A new study published in the Journal of Adolescent Research identifies themes in Asian-American adolescents' attitudes/beliefs regarding how health care providers can be most helpful in communicating about sexual-health topics. Glenn Flores, MD, Distinguished Chair of Health Policy Research at the Medica Research Institute, served as senior author of the study.

In a series of interviews with 20 Asian-American adolescent participants, the researchers identified several key themes, including:

• Confidentiality concerns. Asian-American adolescents desired to have health care providers initiate conversations about sexual health, as the teens are often too embarrassed or afraid to bring up the topic. Asian-American adolescents were unaware of provider-patient confidentiality regarding sexual-health discussions. These confidentially concerns resulted in lying to health care providers about sexual histories or refusing hormonal contraception. Adolescents stated that they would be more honest with providers if clinicians informed them about their right to confidential care.
• A general lack of knowledge regarding sexual-health topics. Asian-American adolescents reported a general lack of knowledge regarding STIs and contraception, compared with their non-Asian peers. A main contributing factor was a lack of discussion with parents about sexual health.
• A hesitancy to discuss sexual histories with Asian-American healthcare providers. Asian-American adolescents stated that they are more hesitant to discuss their sexual activities and sexual history with Asian health care providers, who were viewed as more likely to breach confidentiality and be more judgmental. Adolescents feared that an Asian healthcare provider would feel a "duty" to tell adolescents' parents about their sexual behaviors.

"Our study findings reveal that when communicating about sexual health with Asian-American adolescents, it may be most beneficial for health care providers to discuss confidentiality before initiating conversations about sexual health, abstinence, STIs, and pregnancy prevention," said Flores. "Our findings also indicate that Asian-American adolescents desire more communication and education regarding sexual-health topics with health care providers."