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Sarah is a 23 year old woman. She comes to your office complaining of an increase in vaginal discharge.

  • You ask her if she is sexually active and she says yes.

  • You ask her whether she uses condoms or not and her answer is no.

  • You ask her whether she uses any form of birth control and she says no.

  • You then proceed to tell her that she should be using condoms every time she has sex to decrease her chances of contracting a sexually transmitted infection, and that by not using condoms she is putting herself at risk for HIV, other STIs and pregnancy.

  • You then tell her you are going to do a pelvic exam and ask her when she last had a PAP smear.

  • She tells you that she hasn’t had one in a number of years, then tells you that she can’t have one now as she is menstruating. Sarah then leaves your office and does not return.


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