Mary Jane, a healthy 22-year-old woman, is seen in a walk-in clinic for abnormal vaginal discharge. She is otherwise healthy and not taking any medications. Her immunizations are up to date, though she is unsure if she received the HPV vaccination as a teen. Mary Jane has been sexually active for 2 years. She has never had a Pap smear. She tells you that she has tried the birth control pill in the past but is not taking it because it “makes her sad”. She uses condoms instead. Three months ago, she had unprotected sex one time with her current partner. She confides in you that she thinks her current partner "sleeps around" on her and she’s here today because she wants to get “checked”. When taking a detailed sexual history, you discover that she has intermittently experienced pain during sexual intercourse and some post-coital bleeding. Mary Jane minimizes these symptoms and tells you that this is normal for her. On examination she looks well but is very nervous. Vitals signs are within normal limits. Head and neck, respiratory and cardiac examinations are all normal. Abdominal exam does not reveal any masses or areas of tenderness. Skin and joints are all normal. Genital examination does not reveal any lesions. Pelvic examination reveals some purulent discharge from the cervical os. Swabs are collected from the cervical os and result in bleeding. Bimanual examination does not elicit any cervical or adnexal tenderness. You discuss the role of cervical cancer screening and how it relates to HPV, a sexually transmitted infection. Mary Jane agrees to return in 2 weeks for a Pap smear.