Background/Purpose: Systemic Lupus Erythematosus (SLE) is an autoimmune disease that is known to target young adults, especially women of child-bearing age. Although it is well-accepted that teratogenic SLE medications can cause negative pregnancy outcomes, there has been little research conducted to examine sexual health and contraceptive counseling among young adults with SLE, specifically teens and adolescents.  The purpose of this study is: 1) to determine how much female adolescents with SLE know about their disease, SLE medications, how SLE relates to their sexual health, and how SLE symptoms can be impacted by pregnancy, STDs and contraceptives containing estrogen. 2) to educate the same group of patients about sexual and reproductive health using a face-to-face counseling session. 3) to reassess their knowledge after the intervention.

Methods: Female adolescents with SLE were recruited from the MUSC Pediatric Rheumatology clinic. Information on age, race, gender, medications, previous pregnancies, and length of diagnosis with SLE was obtained. The questionnaire (31 items regarding SLE medications, contraceptives, and STD’s) was completed by all subjects before and after the intervention, which was a face to face educational session. The resulting data was analyzed by using a paired t-test.

Results: 13 female SLE patients, ages 12-21, were studied (11 African Americans, 1 Caucasian, 1 other). The average percent correct on the pretest questions was 30.8% on questions regarding the effects of SLE medications on pregnancy, 38.8% on questions regarding contraceptives, and 78.8% on questions regarding sexual health and STD’s. The average percent correct on post-tests for those 3 categories of questions were 88%, 77%, and 99% respectively. The average improvement between pre- and post-tests for the 3 categories were 57.7% with a p-value of 0.0001, 46.2% with p-value of 0.0001, and 20.2% with p-value of 0.0006 respectively.

Conclusion: The low scores on the initial baseline assessment show that SLE adolescents are under-educated about contraceptives and the effects of SLE medications on pregnancy. After the counseling session, the average percent correct scores on the post-test significantly improved in all 3 categories. The issues surrounding contraceptives and pregnancy are important for this population, and it is imperative to advise SLE adolescents and teens on effective contraceptives in order to avoid unplanned pregnancies with unfavorable outcomes. This study demonstrates the need to establish routine counseling on contraceptives and reproductive health for women with SLE.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/sexual-and-reproductive-health-counseling-among-adolescents-with-systemic-lupus-erythematosus/