Topic Progress:
 
As in any teenage, start history with ( At OSCE) 
1. explaining the concept of confidentiality 
eg – everything we discuss in this consult will remain within us, unless your life or someone  else’s life is at risk. 
2. Do a HEADASS assessment 
Home environment ( Homelessness, Domestic violence, overcrowdedness common in ATSI community) 
Education / Employment – school environment, any issues at work ( unemployment common in ATSI community)
Activities ( Gambling common in ATSi community) 
Depression – mental health ( common in ATSI community ) 
Alcohol and other drugs ( common in ATSI community ) 
Sexual activity / Sexual orientation / Sexual abuse ( Sexual abuse and non consensual sex – common in ATSI community) * – refer below on sexual and reproductive history 
Safety – (Safety at home should be inquired ) 
3. Consider SCOFF questains – for eating disorder ( don’t need to ask in all teenager ) 
      • do you make your self sick after meals because you feel uncomfortable 
      • do you think you have lost control of how much you eat 
      • have you lose over one stone over 3 months of body weight 
      • do you consider your self fat when others say you are thin 
      • do you think food dominates your life 
* Sexual History – 
      • Are you sexually active ?
      • Age of partner – important in ATSI specially 
      • When is the last time you had sex
      • When did the last time you had a different partner and do you have multiple partners – important in ATSI specially 
      • Is your partner a male / female or do you have sex with both 
      • If partner is HIV positive – know 1) is he on ART, 2) viral load detectable, 3) is he/you circumcised)
      • If men having sex with men ( MSM) – Are you top or bottom – and did he cum inside you 
      • Are you circumcised 
      • Did you have sex overseas or have your partner traveled overseas recently or is he/she from overseas
      • Is you partner having multiple sexual partners, IV drug abuse or has STD – important in ATSI specially 
      • What sort of sex do you have – anal / vaginal / oral – if homosexual – giver or the taker 
      • Do you use condoms and for what acts
      • Is sex consensual – important in ATSI specially 
      • Have you had tattoos / IV drugs – important in ATSI specially 
      • Have you had STD ?
      • ask MSM high risk questains ( refer to STD chapter ) 
* Reproductive history – 
      • At what age did you have menarche 
      • Were the cycles regular
      • Any symptoms with the cycles ( mid cycle pains)
      • When did the first intercourse happen 
      • Have you had kids, pregnancies, abortion or miscarriage
      • Are you sexually active 
      • Any issues with sex  -( loss of libido, dyspareunia, bleeding )  
      • History of STD
      • Do you have contraception ( have you used emergency contraception , do you use withdrawal method as contraception ) 
      • Are you planning pregnancy and what would you feel if you become pregnant 
      • Have you had HPV vaccination ( if young ) 
      • Is PAP/CST up to date  ( once over 25 years ) 
      • Are you in menopause  – symptoms of menopause ( to be asked in females in 40s and 50s )
 
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