(103) Sexual & Reproductive Health Needs and Care Among Adolescents with Congenital Heart Disease

Background: Prior studies of sexual and reproductive health (SRH) among teens with congenital heart disease (CHD) focus primarily on females and risks of contraception and pregnancy, neglecting other aspects of SRH care, including sexually transmitted infections (STI), adolescent relationship abuse (ARA), and male SRH. We aim to assess global SRH experiences and needs among teens with CHD.

Methods: This convenience survey study (IRB# 3198) is enrolling adolescents aged 14-19 with CHD and their parents at clinic visits at a single tertiary children’s hospital. Participants complete an anonymous REDCap survey; data to date is summarized with descriptive statistics.

Results: Thirty adolescents and 32 parents have participated to date (table 1) .
Among teens, 30% reported sexual activity; none reported prior STI testing. Out of the 66% who reported dating, 70% had dated 2 or more people and 20% reported ARA. 83% reported talking to their parents about dating; 80% reported talking to their parents about sex. 50% reported prior conversation with a healthcare provider (HCP) about SRH and 40% about dating. Most SRH conversations were with their primary care provider (PCP). 67% reported prior confidential conversation with their PCP; 30% reported confidential conversation with their cardiologist. SRH topics discussed in the past year with a HCP included ARA (30%), changes during puberty or safe sex practices (30%), STIs (33%), and, among females, menses (78%), contraception (22%), and pregnancy risks (11%). Most agreed that HCP should talk about SRH with teens with CHD (87%); 50% agreed that a cardiology clinic appointment was a good opportunity to address SRH (Table 2).
Among parents, 96% had talked to their teen about dating, 81% about ARA, and 90% about sex. 84% agreed that HCP should discuss SRH with teens with CHD; 52% agreed that cardiology clinic provided a good opportunity for such discussions (Table 2).

Conclusions: This survey highlights that teens with CHD have SRH needs similar to their non-CHD peers; some are dating, some are sexually active, and some experience ARA. Our findings suggest missed opportunities for SRH care among these teens; only half reported a conversation with a HCP about SRH and a minority reported a conversation about dating. However, most teens and parents agreed that SRH care is needed for teens with CHD. Our findings suggest cardiology clinic appointments may offer opportunity for SRH care and highlights the barriers and gaps in SRH care for teens with CHD.