Promoting safe sexual practices and sexual health maintenance in pediatric and young adult solid organ transplant recipients.
Monica I ArduraLisa A CosciaMelissa R MeyersPublished in: Pediatric transplantation (2021)
The majority of Americans make their sexual debut during their adolescent years. Preventing pregnancy and STI during this period is vital to ensuring health and safety. As survival has improved after pediatric SOT, chronically immunosuppressed adolescents seek guidance in their medical home on matters of sexual health. Transplant practitioners often do not feel equipped to fully address these needs. This review serves as an introductory sexual preventive care resource for adolescent and young adult (AYA) SOT recipients. First, we review data on safety, efficacy, and use of contraceptive options currently available for transplant recipients with child-bearing potential. Then, we suggest a personalized sexual health discussion focusing on the diagnosis and prevention of STIs in adolescent and young adult transplant recipients. Finally, we present recommendations for STI screening of asymptomatic patients, use of index of suspicion and diagnostic testing in symptomatic patients, and opportunities to optimize STI prevention strategies. Data compiled from studies of adult SOT recipients, general population studies, and published guidelines are often extrapolated for use, as limited data exist in AYA SOT recipients. This informational dearth underscores the need for future research to better characterize the unique needs of AYA SOT recipients.
Keyphrases
- young adults
- mental health
- childhood cancer
- healthcare
- end stage renal disease
- ejection fraction
- primary care
- newly diagnosed
- chronic kidney disease
- electronic health record
- men who have sex with men
- prognostic factors
- big data
- kidney transplantation
- climate change
- systematic review
- clinical practice
- risk assessment
- artificial intelligence
- preterm birth
- quality improvement
- patient reported
- deep learning
- data analysis
- general practice