Introduction: Adult transplant recipients demonstrate poor reproductive health literacy and risky sexual behaviors; adolescents and young adults’ (AYA) experience has not been examined. This study assesses kidney and heart transplant AYA patients’ knowledge of sexual and reproductive health to better understand the needed education and intervention.
Methods: AYA (16-23yo) completed an anonymous survey in clinic or by confidential online link. The survey included 13 items on sexual health knowledge and 11 items on reproductive health. 31 patients completed the survey, mean age 18.9 years, 18 kidney, 13 heart, self-identified 17 males, 12 females, 25 straight.
Results: 17 patients reported having been sexually active. 2 patients (both female) noted concerns about sexual functioning. All patients were aware of condoms; 3, 14, 16, and 20 patients had not heard about general contraception, emergency contraception, pre-exposure prophylaxis for HIV prevention, and post-exposure prophylaxis for sexually transmitted infection prevention, respectively. 6 patients felt neutral confidence in sexual health knowledge while others were somewhat or very confident. One patient was uncomfortable talking to healthcare providers about sexual health, 8 were neutral, and others were somewhat or very comfortable. 18 patients had received sexual health education from their providers, 16 of them found the education somewhat or very useful. 23 patients noted wanting a child in the future and others were unsure or had not thought about it. 9 patients had concerns about having a child biologically/naturally. 14 patients noted concerns about pregnancy on transplant medications. 7 patients (3 males, 4 females) noted worries about their ability to be good parents as a transplant patient. 8 patients noted worries about life expectancy in relation to having and raising children. 16 patients are worried about passing on their medical condition to their offspring. 2 patients were not confident about reproductive health knowledge, 7 were neutral, and others were somewhat or very confident. 12 patients had neutral feelings talking about reproductive health with providers; others were somewhat or very comfortable. 16 respondents reported receiving reproductive health education from providers; others were unsure or had not received it. Of those who had received reproductive health education, 2 were neutral on how useful they found it; others found it somewhat or very useful.
Conclusion: Some transplant AYA recipients report appropriate knowledge of sexual and reproductive health; however, many demonstrated limited knowledge regarding contraception, STI prevention, and reproductive issues as they pertained to their medical care. Moreover, many AYA transplant recipients expressed discomfort communicating with providers. This study highlights the need to assess all transplant recipients’ sexual and reproductive health needs in order to provide appropriate educational support.