Lesson 1Vaccination, prevention counselling, barrier methods, and harm reduction (HPV vaccine, condom use, PrEP indications)This section covers primary and secondary STI prevention, including HPV and hepatitis vaccinations, condom and barrier method counselling, PrEP and PEP indications, harm reduction for substance use, and motivational interviewing to encourage safer behaviours in young people.
HPV, hepatitis, and other relevant vaccinesCondom and barrier method selection and teachingHIV PrEP indications, labs, and adherence supportPost-exposure prophylaxis in sexual exposuresHarm reduction for substance use and chemsexMotivational interviewing for risk behaviour changeLesson 2Confidentiality, parental involvement, and legal/ethical considerationsThis section explores confidentiality in adolescent care, parental involvement, and legal frameworks, including minor consent laws, documentation, billing risks, mandatory reporting, and strategies to safeguard privacy while fostering family relationships in Botswana.
Minor consent laws for sexual health servicesExplaining confidentiality and its limits to teensEngaging parents while preserving teen privacyMandatory reporting of abuse and statutory rapeDocumentation, portals, and insurance billing risksEthical dilemmas and practical case examplesLesson 3Focused sexual and social history for adolescents (partners, consent, abuse screening, contraception goals)This section describes a focused, age-appropriate sexual and social history, covering partners, practices, pregnancy intentions, consent, abuse screening, mental health, and integrating contraception and STI prevention goals into care for Botswana adolescents.
Establishing rapport and confidentiality limitsAssessing partners, practices, and pregnancy riskExploring gender identity and sexual orientationScreening for coercion, abuse, and traffickingContraception goals and reproductive life planningMental health, school, peers, and digital behavioursLesson 4STI risk assessment and symptom-directed questions (exposure, discharge, dysuria, rectal/oral exposure)This section outlines structured STI risk assessment for adolescents, including targeted questions on exposures, symptoms, partner factors, and substance use, using nonjudgmental, inclusive language and trauma-informed, age-appropriate interviewing techniques.
Core elements of adolescent STI risk historySymptom review: discharge, dysuria, lesions, painAssessing oral, anal, and genital exposure patternsPartner number, gender, concurrency, and networksSubstance use, coercion, and impaired consent risksNormalizing, inclusive, and trauma-informed languageLesson 5STI testing algorithms and interpretation (NAAT for chlamydia/gonorrhea, HIV, syphilis serology, hepatitis B/C testing)This section explains STI testing strategies for adolescents, including site-specific NAATs, HIV and syphilis screening, hepatitis testing, window periods, result interpretation, and clear, sensitive communication of results and next steps.
Choosing tests based on exposure and symptomsNAATs for chlamydia and gonorrhea at all sitesHIV testing options, windows, and acute infectionSyphilis serology algorithms and staging cluesHepatitis B and C screening and follow-upCommunicating results, uncertainty, and retestingLesson 6Contraceptive options: mechanism, effectiveness, indications, contraindications, and adolescent counselling (LARC, implants, IUDs, combined and progestin-only methods, emergency contraception)This section reviews contraceptive methods for adolescents, including LARC, pills, patch, ring, injection, and emergency contraception, emphasising mechanisms, effectiveness, contraindications, side effects, and shared decision-making counselling.
Overview of LARC: implants and intrauterine devicesCombined hormonal pills, patch, and vaginal ringProgestin-only pills and injectable contraceptionEmergency contraception methods and timingMedical eligibility, contraindications, and risksShared decision-making and adherence strategiesLesson 7Management of common STI results and partner notification principles (treatment regimens for chlamydia, gonorrhea, trichomonas, herpes)This section addresses evidence-based management of common adolescent STIs, including first-line and alternative regimens, test-of-cure indications, expedited partner therapy, counselling on transmission reduction, and documentation and follow-up planning.
Treatment regimens for chlamydia in adolescentsUpdated gonorrhea therapy and resistance concernsTrichomonas diagnosis, treatment, and retestingGenital herpes counselling, episodic and suppressive careExpedited partner therapy and partner notificationFollow-up, test-of-cure, and reinfection preventionLesson 8Physical exam approach for adolescents (general exam, abdominal, external genitalia, pelvic when indicated)This section reviews a stepwise adolescent physical exam, stressing privacy, chaperones, and consent, with guidance on general, abdominal, and external genital exams, and when and how to conduct pelvic or speculum exams safely and respectfully.
Preparing the room, chaperone, and privacy stepsExplaining exam steps and obtaining assentGeneral and abdominal exam for STI complicationsExternal genital and perineal inspection techniquesIndications for bimanual and speculum examinationManaging anxiety, pain, and prior trauma history
