Doctors can bridge sex knowledge gap for teens

Washington -- It should come as no surprise that teens think they know it all. But when it comes to contraception and protection from sexually transmitted diseases, the gap between what they think they know and what they actually do know is tragic.

Teens are disproportionately affected by the nation's epidemic of STDs, including HIV. By age 25, one of two sexually active young people will acquire a sexually transmitted disease, according to a University of North Carolina study released last spring.

And a lack of understanding might be one of the key problems.

While the majority of the 500 teens age 15 to 17 who participated in a recent Kaiser Family Foundation phone survey knew about birth control pills, more than one in four of that majority didn't know that oral contraceptives offer no protection against sexually transmitted disease.

The survey was part of an education campaign by Kaiser and Seventeen magazine, called SexSmarts, which is intended to increase teens' knowledge about sex.

And for many, the findings were not unexpected.

"I think the survey reflects what I see in my general practice," said Michelle Barratt, MD, associate professor of pediatrics at the University of Texas Medical School in Houston.

The findings also underscore the important role of physicians as health educators. While many teens surveyed said they are getting their information about contraceptive options from their friends and product advertising, nearly half named their physician or other health care professional as sources of information.

Dr. Barratt would like to see physicians take advantage of that opportunity. She teaches third-year medical students how to talk to teens about sex. And teens should be presented with the option of abstinence, she said. Some of the physicians she trains believe it's not their place to tell somebody what the best choice is, but "we do it all the time with smoking."

"From my perspective, physicians should start early, when a prepubertal 9- or 10-year-old comes in for a well-child checkup," advised Dr. Barratt. Physicians should model for parent and child the conversations that should occur on a regular basis at home so children become familiar with the values and expectations of their parents before "they have chosen their boyfriend and all their hormones are raging."