A sexually active 17-year-old boy reports unprotected sex recently. Which care approach is most appropriate?

A sexually active 17-year-old boy reports unprotected sex recently. Which care approach is most appropriate?

• A. Complete blood count and penile smear for gonorrhea
• B. Physical examination, STD history and screening tests, immunization update, anticipatory guidance regarding responsible and safe sexual behavior, and recheck in 6 months
• C. Evaluation of immunization status, hepatitis B screening panel, HIV screen, and penile smear for gonorrhea
• D. No tests because the patient is asymptomatic, anticipatory guidance, and recheck in 6 months

Answer: (B)

When a sexually active adolescent has had unprotected sex, the best approach is a comprehensive, confidential review that combines STI screening, up-to-date immunizations, and guidance on safe sexual practices, with a plan for follow-up. Begin with a thorough assessment and perform appropriate STI screening using current tests. For sexually active teens, screen for gonorrhea and chlamydia with nucleic acid amplification tests, using the most appropriate specimen (urine or swab) rather than older smear methods, even if the patient has no symptoms. Include HIV screening given the risk profile. Immunization status should be reviewed and updated as needed, including HPV vaccination for young males and Hepatitis B vaccination if not already completed. Provide anticipatory guidance about responsible and safer sexual behavior, including condom use, partner communication, disease prevention, and the importance of routine follow-up. Arrange a recheck in about 6 months or sooner if symptoms develop. This approach is preferable because it addresses potential asymptomatic infections, reduces future health risks, and supports vaccination and risk-reduction counseling. It avoids unnecessary tests (like a complete blood count) and outdated testing methods, and it recognizes that no testing in the setting of recent unprotected sex would miss treatable conditions and opportunities for prevention.

When a sexually active adolescent has had unprotected sex, the best approach is a comprehensive, confidential review that combines STI screening, up-to-date immunizations, and guidance on safe sexual practices, with a plan for follow-up.

Begin with a thorough assessment and perform appropriate STI screening using current tests. For sexually active teens, screen for gonorrhea and chlamydia with nucleic acid amplification tests, using the most appropriate specimen (urine or swab) rather than older smear methods, even if the patient has no symptoms. Include HIV screening given the risk profile. Immunization status should be reviewed and updated as needed, including HPV vaccination for young males and Hepatitis B vaccination if not already completed. Provide anticipatory guidance about responsible and safer sexual behavior, including condom use, partner communication, disease prevention, and the importance of routine follow-up. Arrange a recheck in about 6 months or sooner if symptoms develop.

This approach is preferable because it addresses potential asymptomatic infections, reduces future health risks, and supports vaccination and risk-reduction counseling. It avoids unnecessary tests (like a complete blood count) and outdated testing methods, and it recognizes that no testing in the setting of recent unprotected sex would miss treatable conditions and opportunities for prevention.