Teen +HSVII + pap guidelines?

Specialties NP

Published

Hi all....I have a new pt who was dx'd with HSV II last year...she's 16-years-old....I'm wondering if anyone knows if the pap guidelines would deem her for paps now? I know she had one last year with the diagnosis, but I'm not sure now if she needs regular follow up paps or wait until 21?

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If she had one last year at diagnosis and it was negative for hpv/atypical cells then I would probably wait until age 21 to repeat unless there was indication for further testing which I believe is immunocompromised states or HIV.

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Thanks!

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ACOG recommends against screening until age 21, unless the patient has HIV or is otherwise immunocompromised:

ACOG - Cervical Cancer in Adolescents - Screening Evaluation and Management

ACOG - Exceptions to Pap Screening in Adolescents

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Specializes in FNP, ONP.

You know, this irritates me beyond words- providers who don't follow the guidelines. Not you OP, the person before you who did the unnecessary pap along with the diagnosis of HSV. I know, I know, it was "just to be on the safe side."

Arrrrgghh!When we come behind them and tell pt/parents that repeat pap is not indicated, they think we are slack. They insist, "just in case." We either make them angry or end up running up health care costs with inappropriate testing. As I am a male and cannot afford any appearance of impropriety with regard to unnecessary lady partsl exams (!), I opt for looking slack in Mom's eyes, lol, but it is ridiculous.

FOLLOW THE MOTHER BLESSED GUIDELINES PEOPLE!!! YOU DO NOT KNOW BETTER THAN ACOG.

that is all, thanks for letting me get that off my chest.

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I am so with you, BlueDevil! Makes me a crazy AtomicWoman when providers either ignore guidelines or are too lazy to look them up!

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Specializes in ER.

Check out the ASCCP iPhone app! It's a great tool.

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You know, this irritates me beyond words- providers who don't follow the guidelines. Not you OP, the person before you who did the unnecessary pap along with the diagnosis of HSV. I know, I know, it was "just to be on the safe side."

Arrrrgghh!When we come behind them and tell pt/parents that repeat pap is not indicated, they think we are slack. They insist, "just in case." We either make them angry or end up running up health care costs with inappropriate testing. As I am a male and cannot afford any appearance of impropriety with regard to unnecessary lady partsl exams (!), I opt for looking slack in Mom's eyes, lol, but it is ridiculous.

FOLLOW THE MOTHER BLESSED GUIDELINES PEOPLE!!! YOU DO NOT KNOW BETTER THAN ACOG.

that is all, thanks for letting me get that off my chest.

YES!! This has been an endless problem at this clinic and it's extra difficult bc I'm a new grad, and the other providers make me feel like I don't know what I'm talking about! AND, the patients have been told certain things so when I explain why they don't need pats every year, etc, they almost don't believe me....it drives me crazy....and it's completely insane when I have pts who get their paps done through a gynecologist and the gyn still is doing them every year!!?? WTH????

Thanks....this is why I wanted to run this case by you bc I wasn't sure if the new guidelines pertained to HSV....Mom was convinced her daughter needed the pap, but I quick looked at my algorithm and didn't do one.....but they all questioned me so much I started doubting my decision....uughgh!

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Or how about 75-year-old patients that have never had an abnormal Pap, and they still get a Pap every year! Argh!!!!

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