4/22 Adolescent Sexuality Flashcards

1
Q

In terms of sexuality development, what are teens doing as pre-adolescents?

A

Gender identity and gender roles

They will start identifying genders

What boys and girls are “supposed” to do

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2
Q

In terms of sexuality development, what are teens doing as early adolescents (ages 10-13)?

A

Going through early pubertal changes

having sexual fantasies and masturbation

First crushes

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3
Q

In terms of sexuality development, what are teens doing in middle-adolescence (ages 14-16)?

A

Physical maturity reached

Early sexual exploration, coital and non-coital

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4
Q

In terms of sexuality development, what are teens doing in late adolescence (ages 17+)?

A

adult, intimate sharing relationships

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5
Q

Biologic sex: define

Gender identity: when can kids identify this?

Gender roles: when can kids identify this?

Sexual orientation: what % of teens question?

Sexual behavior: aligned with sexual orientation?

A

Biologic sex: interplay of chromosomes & hormones

Gender identity: kids can identify by age 2 or 3

Gender roles: kids can identify really early

Sexual orientation: 15% of teens question, 5% identify as gay/les

Sexual behavior: may or may not align with sexual orientation

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6
Q

What behaviors and situations are LGBTQ youth at increased risk for?

A
  • Suicide (33%)
  • Homelessness
  • Substance abuse
  • Violence, victimization
  • STIs (HIV rising for young MSM)
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7
Q

What % of high schoolers have had sex at least once?

what % are currently sexually active (past 3m)?

A

50% of 9th-12th graders have been SA at least once

33% within past 3m

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8
Q

median age of sexual debut?

A

17

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9
Q

what correlates with a younger age of sexual debut?

A

The younger the age of sexual debut, the more likely they were to have been coerced

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10
Q

What % of all STIs are diagnosed in patients aged 15-24?

What % of teen pregnancies are unplanned?

A

50% all STIs = in ages 15-24

80% teen pregnancies are unplanned

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11
Q

Since the 1990s, has the % of HS students who have had sex gone up or down?

What about condom usage?

What about “safer” sex (ie BC method + condom)?

-What about alcohol/drug use before sex?

A

Since the 1990s:

  • % of HS students who have had sex: decreased
  • condom usage: increased
  • “safer” sex (ie BC method + condom): trend unknown, currently 9% total
  • alcohol/drug use before sex? increased then decr: about the same now
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12
Q

Do virginity pledges work?

A

Um, no.

  • 5 yrs later, 82% denied that they ever pledged.
  • Fewer pledgers than nonpledgers used birth control and condoms in the past year and birth control at last sex
  • 10% of self-reported abstinent youth had STIs
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13
Q

Screening recommendations for PAP smears?

A

Begin screening at age 21.

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14
Q

Define:

Age of majority

Emancipated minor

Mature minor doctrine

A

Age of majority: age of full decision making capacity (generally 18)

Emancipated minor: Legal definition. Achieved “adult” milestones including military service, marriage, parenthood, independent financial status

_Mature minor doctrine: _—Based on context. common-law rule that allows an adolescent who is mature to give consent for medical care

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15
Q

What determines Confidentiality when it comes to adolescents?

Adolescents are protected by what laws?

A

Confidentiality is state-dependent

Adolescents are protected by:

minor consent laws

HIPAA

State Medical Privacy Laws

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16
Q

What are some limitations to confidentiality laws?

A
  • Emergency care
  • Reproductive care (pregnancy, contraception, STI testing/tx)
  • Mental health care
17
Q

Local regulations for NH/VT:

Minor til what age?

Confidential STD testing/tx at what age?

Parental notification for abortion?

Sex ed requirements?

A

VT:

Minor til 18

Confidential STD testing at 12; parents notified for treatment

Parental notification for abortion: —no requirement for parental notification or judicial involvement; Medicaid pays; no waiting period

Sex ed: —required; must state that abstinence is only way to prevent pregnancy/STD

NH

—Minor til 18

Age 14 for reproductive health care —

Abortion: no requirement for parental notification or judicial involvement; Medicaid does not pay except for rape or incest; no waiting period —

Sex ed not mandatory in NH; if taught must state that abstinence is only way to prevent pregnancy

18
Q

Define age of consent.

What is it in NH/VT?

A

Age of consent = minimum age to legally have sex

—In NH/VT the age of consent and minimum age to (legally) have sex is 16

19
Q

What are Biological risk factors for STIs in adolescents?

A
  • Immature cervix with ectopy (columnar cells exposed to the vag environment, more easily colonized with CT)
  • Naive immunity
  • Higher risk for forced sexual activity
20
Q

What are some developmental risk factors for STIs in adolescents?

A

—-Concrete thinking /Don’t plan ahead… — —

  • Difficulty assessing risk: they are egocentric & invincible, they think that the partner is a good person therefore no STI’s)
  • Higher number of sexual partners — —
  • Risk of coerced sex — —
  • Concomitant substance use
21
Q

STI rate of CT in adolescents compared to general population?

GC?

A

CT: 5x the rate of the general population

GC: Age 15-24 = 4x the rate of the general population

22
Q

Screening recommendations for sexually active adolescents - for CT/GC? HIV?

A

CT/GC: urine based testing yearly

HIV: consider Rapid HIV screening

23
Q

What is the relative rate of HPV and cervical dysplasia in adolescents? Why is the recommendation to start screening at age 21?

A

Higher prevalence of HPV infection and cervical dysplasia (due to immature cervix) in the adolescent population

but most HPV infection will spontaneously resolve in 1-2 years and true cervical cancer is very rare.

24
Q

Prevention strategies?

A

Immunizations (HPV, Hep B)

Condoms

Education