Use Every Episode of Care With Adolescent Patients to Assure Genital Health
Madan Dharmar MD
What to Do – Gather Appropriate Data
Adolescence is an important developmental period with regard to sexuality and sexual behavior. Adolescents are at increased risk for sexually transmitted diseases (STD) for a variety of several behavioral and biological factors. Age at first intercourse and time between menarche and first intercourse, number of sexual partners, partners with multiple other partners, inconsistent protected sex, and alcohol and drug abuse are some of the behavioral factors associated with increased STDs in adolescents. Cervical ectopy or cervical immaturity and low levels of secretary immunoglobulin A (IgA) in adolescent females make them more susceptible to STDs.
When addressing the issue of STDs in adolescents, unique factors such as consent for diagnosis and treatment, confidentiality, parental notification, and mandatory reporting of sexual activity need to be kept in mind. Several of these issues, including behavioral and biological factors, should be addressed by clinicians who provide services to adolescents. Clinicians can also address the lack of knowledge and awareness about the risks and consequences of STDs and offer guidance, constituting true primary prevention, to help adolescents develop healthy sexual behaviors and prevent patterns of behavior that can undermine sexual health.
Assessing Sexual Health in an Adolescent:
Clinical preventive services provided during an office visit must include screening for sexual behavior that may result in unintended pregnancy and STD, and screening for STDs in a sexually active patient. A great proportion of adolescents are not evaluated for risk of acquiring STDs during their office visit. Owing to an increased incidence of some STDs in adolescents, it is important for clinicians to assess the individual’s sexual activity. Presenting symptoms and signs in a patient can be useful for obtaining relevant history and appropriate examination and tests to diagnose STDs. Common presentations of STDs are vaginal/ urethral discharge, skin lesions, genital ulcers, and pelvic inflammatory disease (PID).
Chlamydia Infection in Adolescents:
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