What To Tell Your Patients

Talkin' 'bout birds and bees, yo'

Give your teen patients the 411 on sex. And make yourself heard over the blare of the MTV generation.

By Julia Cyboran

At 14 Melissa Sevigny never thought that she'd be sitting in the ER waiting to be tested for a sexually transmitted infection (STI). She made the common mistake of thinking that there was no chance she could get one � her partner claimed to be STI-free. Turns out that Melissa isn't alone.

Melissa is sexually active, and just like her peers, she's also unaware of the serious dangers that accompany such 'grownup' behaviour. The risky business of sex is making headlines with recent studies from most Western nations reporting huge rises in chlamydia, syphilis and other infections. One Toronto Star article reported, "They're back!"

So, in a world where teens are getting into sex at a younger age, where does the family physician step in? What role can a GP play in sex ed and prevention?

According to Kristine Good, a public health nurse in the Whistler area and the spokesperson for a recent STI awareness campaign called, 'Chlamydia Get Rid of Ya,' the main thing is to get the information across and make teens feel comfortable. "It's important to get teens the information they need. They have to know that unprotected sex is dangerous sex."

IS ORAL SEX SEX?
Another one of the recurring trends is the rising popularity of oral sex in this group. "A lot of kids don't think they're having sex even though they are engaging in oral or anal sex," explains Dr Nicolette Caccia, a Toronto Ob/Gyn who has been working with teens for over 15 years. Many youths and even university students are under the false impression that oral sex isn't actually sex and is therefore safe. A recent study by New Brunswick sociology professor Sandra Byers states that 75% of university students didn't think oral sex was sex. Because of the nonchalant attitude towards oral sex, many teens and young adults aren't protecting themselves � condoms and dental dams are a thing of the past. So, in order to stop the spread of these infections, teens have to get in the know, and one of the best ways to get the message across is through you, their doctor.

Talking to teens about sex and STIs can be tricky. Right off the bat the situation is ill fated � teens are usually embarrassed when it comes to talking to adults about their sexuality. Use these tips to help approach them in the right way and make a strong impression.

HOW TO TALK TO TEENS ABOUT SEX •Confidentiality: A lot of adolescents hesitate to talk about sex with their FP because they fear their parents will find out. "You have to make sure you have a good rapport with the teen. If they see you as their parents' doctor they'll feel like they can't talk to you. You have to routinely exclude their parents from the exam," says Dr Caccia •Don't judge: The teen has to feel like you aren't singling them out. "In my practice I always include questions about sex on my intake sheets, that way they know it's part of a regular exam and I'm not picking on them because they 'look' like they have sex," Dr Caccia adds •Private time: Dr Caccia explains that in her practice she fosters private time with her teen patients, without their parents. "We talk about things like school and life," she says, "or other health problems like incontinence. If you start this communication at an early age it opens those lines up and the teen is more candid later on" •Condom talk: Education is key with these kids. They need to know how effective condoms are and when to use them. Dr Caccia suggests you keep pamphlets available around the office, preferably in places where the teens can pick them up without anyone noticing