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Feature Article

Sexual health risk assessment in adolescents and young people

SUZANNE RIX, DANIELLE SAMMUT, RICK VARMA
OPEN ACCESS

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© MONKEYBUSINESSIMAGES/ ISTOCKPHOTO.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Undertaking a sexual health assessment in adolescents and young people remains a daunting task for many GPs. Being prepared and having a clear framework for assessment helps GPs to be effective in supporting young people to achieve optimal sexual health.

Key Points

  • Good sexual health includes freedom from sexually transmitted infections, unplanned pregnancies, sexual coercion and discomfort (physical or psychological) related to a person’s sexuality.
  • Adolescents and young people are the group most at risk of poor sexual health.
  • Good access for testing and treatment, with appropriate education and health literacy and support are important factors in improving the sexual health of young people.
  • GPs are well placed to provide adolescents and young people support with regard to their sexual health.
  • Effective sexual history taking is the first essential step in helping adolescents and young people achieve optimal sexual health.

A sexual health risk assessment is a crucial part of assessing the overall health and wellbeing of a young person. It is designed to identify sexual and other risk-taking behaviours and psychosocial issues. Such an assessment assists in determining the risks of sexually transmitted infections (STIs), unplanned pregnancy, sexual coercion and discomfort (physical or psychological) related to the person’s sexuality. In essence, it involves taking a thorough sexual history and using an adolescent screening tool known as the HEEADSSS assessment that covers home life, education and employment, eating, activities, drugs and alcohol, sexuality, suicide and safety (Table) and is available in full at www.contemporarypediatrics.com/modern-medicine-feature-articles/heeadsss-30-psychosocial-interview-adolescents-updated-new-century-fueled-media.1,2 However, this essential assessment is not always performed because of many barriers. In this article, we aim to provide an overview of the essential components of a sexual health risk assessment for young people aged 12 to 24 years.

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Why it is important to speak to young people about sex

Adolescents and young people have quite limited access to reliable resources related to sexual health. Despite apparent health literacy and ready access to information online, many young people remain ill-informed regarding both pregnancy and the risks of contracting STIs. Adolescents and young people are often more inclined to engage in sexual risk-taking behaviours than other age groups. Accordingly, they remain vulnerable to STIs, unplanned pregnancies, unwanted or regrettable sex and the potential mental health impacts related to sexuality. GPs are well placed to provide both trusted information and practical assistance. 

Pages

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© MONKEYBUSINESSIMAGES/ ISTOCKPHOTO.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY
© MONKEYBUSINESSIMAGES/ ISTOCKPHOTO.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY
Dr Rix is a General Practitioner and Sexual Health Advanced Trainee, Dr Sammut is a General Practitioner and Sexual Health Advanced Trainee, and Dr Varma is a Sexual Health Physician, Staff Specialist and Clinical Services Manager at Sydney Sexual Health Centre, Sydney, NSW.