F Yg OJji 2 G2 Uc 5 SGK 6 X S1 K60 T 896 M Oaee 5 Hulyyg V

SEXUAL HEALTH
ASSESSMENT
Clinical Consultation for Young People: The HEADSS
Assessment Approach
INTRODUCTION:
It is one of your usual days at your clinic and

your first patient is Natasha. Natasha will be
turning 16 in a few months, and she is in her
fourth year of secondary school. Natasha
tells you that she is on her way to school but
needed to see you quickly because she is
experiencing a burning sensation on passing
urine.
How would you approach Natasha’s case?

Sexual history and risk
assessment
It is important to take a sexual history including risk assessment- type,
frequency, protected or non-protected sexual activity).
Its also important to exercise good communication skills:

· Ask permission to ask personal questions.
· Explain why you need to take sexual history.
· Be sensitive, respectful and non-judgmental.
· Avoid lecturing, and telling, rather give options.
You decide to do a HEEADSS assessment, and this is the
information you get:
Home: Natasha stays with her mum and 11-year-old brother. They moved to the area 1-
year ago after her parents separated. She remembers that her parents used to fight a lot,
and she thinks it is right that they choose to separate. She wishes she could talk more with
her dad.
Education: Natasha is in form 4 and doing well in school. She aspires to be an engineer.
Eating and exercise: She is happy with her weight and doesn’t not have eating problems.
Activities: Natasha enjoys hanging around with her friends at school and they usually talk
about relationships and music. During the weekends, she will be at home with her brother
while her mum goes out with her boyfriend. She also enjoys youth activities at church.
You decide to do a HEEADSS assessment, and this is the
information you get:
Drugs and Alcohol: She tells you that she has tasted alcohol twice but did not like it. Her
mum’s boyfriend often leaves some cans of beer in the fridge whenever he sleeps over, and
Natasha takes them to her boyfriend, Mike. Mike tells her that alcohol tastes good, and he will
teach her to enjoy taking it. She has never smoked or used any street or prescription drugs.
Sexuality: Natasha has a boyfriend, Mike, who is 19 years old. Mike works as a driver for a
commuter omnibus. She has had sex twice with Mike, and he is her only sexual partner. They
did not use protection.
Suicide: Natasha is in a happy mood, just concerned about the urine symptoms. She has no
thoughts of suicide.
Considering Natasha’s STI risks, what screening
should she be offered?
Chlamydia
Gonorrhoea
Syphilis
HIV
Vaccinations
Hepatitis B vaccination status
Human Papilloma Virus vaccination status
It is important to discuss with the young person how you are going to give
her/ him the results maintaining confidentiality.
Contraception
Contraception is an important consideration for a sexually active young person.
You can begin with open-ended questions like, "What do you know about contraception?" or
"Have you ever thought about using contraception?"
This allows the teenager to share their existing knowledge and concerns. Listen Actively to their
responses and their feelings and concerns then offer clear, factual information about various
contraceptive methods, their effectiveness, and potential side effects.
Also discuss potential consequences of sexual activity, including unintended pregnancies and
sexually transmitted infections (STIs).
Healthcare providers can encourage open communication between teenagers and their
parents, or a trusted adult. If a teenager chooses not to involve their parents, it's essential to
respect their confidentiality while ensuring they receive appropriate healthcare and education.
What is the best method of contraception
for teenagers?
The choice of contraception for teenagers should be individualised based on sexual activity frequency, medical history, future
family planning goals, and personal preferences. It's essential to thoroughly discuss these factors to determine the most suitable
contraceptive method. Common contraceptive options for teenagers include:
1. Barrier Methods: Condoms (male or female) provide protection against both unintended pregnancies and STIs.
2. Oral Contraceptives (Birth Control Pills): These require daily use and are highly effective when taken correctly.
3. Long-Acting Reversible Contraceptives (LARCs): Options like the intrauterine device (IUD) or contraceptive implant
offer long-lasting protection with fewer user-dependent factors.
4. Injectable Contraceptives: These are administered every few months and can be a suitable option for some
teenagers.
5. Emergency Contraception: Available over-the-counter, emergency contraception can be used after unprotected
intercourse to prevent pregnancy.
Wrapping up
Many adolescents do not recognize dangerous life-style patterns because they see their activities
not as problems but as solutions. The task for clinicians consulting adolescents is in helping the
adolescent to see health risk-taking behaviours as problems and helping to develop better
strategies for dealing with them.
Ask if they are willing to change their lives or are interested in learning more about ways to deal
with their problems. This leads to a discussion of potential follow-up and therapeutic interventions.
Ask if there is any information you can provide on any of the topics you have discussed, especially
health promotion in the areas of sexuality and substance use. Try to provide whatever educational
materials young people are interested in.

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SEXUAL HEALTH

It is one of your usual days at your clinic and

How would you approach Natasha’s case?

Its also important to exercise good communication skills:

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