Sexuality and Reproductive Health Counseling in Adolescent Renal Transplant Recipients

摘要

Normal adolescence marks a period of significant physical, cognitive and psychosocial change. It ischaracterized by transition from concrete to abstract thought processes and concern for risk taking behaviors. Adolescentsand young adults with chronic conditions are at a particular disadvantage and tend to be more vulnerable to risky behaviorthan their healthy peers.While there currently exists no information on the burden of sexually transmitted infections (STIs) in adolescent renaltransplant recipients, they present a particularly worrisome population as they are likely to engage in risk taking behaviorwhen they feel “normal” following transplantation to compensate for poor quality of life endured on dialysis. This isfurther compounded by adolescents’ false perception that they are unlikely to acquire such infections, and the likelyimprovement in libido and sexual functioning after transplantation. The potential for acquiring a sexually transmittedinfection is concerning given their immunocompromised status, and complex treatment regimens which might haveunfavorable interactions with STI treatments.Also, unintentional pregnancy is likely to have a significant impact on their overall medical condition and socialfunctioning thereby impacting their long term allograft outcomes. As the pediatric nephrologist assumes a primary careprovider role for these patients following their renal transplant, it becomes increasingly important to be familiar with basicreproductive health counseling techniques and available contraceptive methods on the market. Until consensus guidelines andspecific recommendations for reproductive health counseling are developed for adolescent renal transplant recipients, thisreview provides a brief summary of available knowledge in those areas.