Original article: integrated healthSexual behaviors, risks, and sexual health outcomes for adolescent females following bariatric surgery
Section snippets
Overview of study design
Participants in the Teen Longitudinal Assessment of Bariatric Surgery consortium (Teen-LABS) (n = 242, age 13–19 yr), a multisite prospective observational safety and efficacy study [29], were invited, if eligible, to participate in a parallel series of independently funded, ancillary studies tracking the psychosocial benefits and risks of bariatric surgery from presurgery and across the first 4 postoperative years. These ancillary studies were enhanced by the inclusion of a comparative
Sample characteristics
Participants were predominantly white (surgical: 63% [n = 70]; nonsurgical: 56% [n = 38]; P = .34), with surgical females significantly older (surgical: 16.95 ± 1.44 yr; nonsurgical: 16.18 ± 1.36 yr; P =.001). The surgical cohort presented with a higher BMI than the nonsurgical cohort at baseline (surgical: 50.99 ± 8.42 kg/m2; nonsurgical: 46.47 ± 5.83 kg/m2; P < .001) and underwent a primary surgical procedure: 66% (n = 73) Roux-en-Y gastric bypass (RYGB), 32% (n = 35) sleeve gastrectomy (SG),
Discussion
The majority of females experienced sexual debut during the 4-year study window (postoperatively for surgical females) at an age consistent with age-normative trends (≈17 yr) and with an increase in past-year sexual risk behaviors over time [1], [2]. However, when considering a broader set of lifetime health risk behaviors known to confer greater risk for acquiring HIV or any STI (i.e., lifetime HIV-Risk score), surgical females demonstrated a significant surge in risk behavior engagement
Conclusions
Reduction of teen pregnancies and child-bearing, unintended pregnancies, and STI/HIV-Risks are public health priorities for all adolescents and young adults [52]. Thus, while many outcomes reported herein fell within age-normative ranges, their impact should not be interpreted as benign. Bariatric care for adolescent females must include ongoing education on dual protection strategies, the impact of substance use on sexual decision-making, STI/HIV prevention, and risks and consequences of teen
Disclosures
Thomas H. Inge has served as a consultant for Zafgen Corporation, Biomedical Insights, and L&E Research, and received honoraria from Standard Bariatrics, UpToDate, and Independent Medical Expert Consulting Services, all unrelated to this project. Anita P. Courcoulas has received research grants from Allurion Inc. David B. Sarwer has served as consultant for BARONova, Merz, and NovoNordisk.
Conflict of Interest
All authors have indicated they have no relationships relevant to this article to disclose.
Acknowledgements
The authors would like to acknowledge the contributions of additional TeenView Study Group Co-Investigators and staff. Cincinnati Children’s Hospital Medical Center: Faye Doland, BS; Ashley Morgenthal, BS; Taylor Howarth, BS; Sara Comstock, MA; Shelley Kirk, PhD; Michael Helmrath, MD, PhD. Texas Children’s Hospital: Margaret Callie Lee, MPH; David Allen, BS; Beth Garland, PhD; Gia Washington, PhD; Carmen Mikhail, PhD; Mary L. Brandt, MD. University of Pittsburgh Medical Center: Ronette Blake,
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