The US Preventive Services Task Force (USPSTF) recently published recommendations on behavioral counseling to reduce sexually transmitted infections (STIs) in adults and adolescents.
Sexually transmitted infections are passed between individuals via sexual contact. Often people with STIs have no symptoms and therefore do not know when they are transmitting them to others. More common STIs in the US include gonorrhea, chlamydia, trichomonas, human papillomavirus (HPV), and genital herpes. Other STIs include HIV, syphilis, hepatitis B, and hepatitis C (although sexual transmission of hepatitis C is rare).
What Does Behavioral Counseling to Reduce STIs Involve?
Behavioral counseling is aimed at increasing knowledge, motivation, and skills for preventing STI acquisition. It provides information about common STIs, modes of transmission, and safer sex practices; assessment of individual risk of acquiring STIs; training in condom use; and communication skills to talk about safer sex.
Behavioral counseling can be done in person or via video, websites, written materials, telephone support, or text messages. It can be done in a group or individual setting.
What Is the Population Under Consideration for Behavioral Counseling to Reduce STIs?
This recommendation1 applies to (1) all sexually active adolescents and (2) adults at increased risk of STIs, including those who currently have an STI or have had one in the past year, those who do not consistently use condoms, those who have multiple sex partners, those who belong to or have sex partners in populations with a high prevalence of STIs (sex and gender minorities, injection drug users, people living with HIV, people who exchange sex for money, and people recently incarcerated).
What Are the Potential Benefits and Harms of Providing Behavioral Counseling to Reduce STIs?
Evidence has shown that behavioral counseling is effective at reducing STI transmission in those at higher risk, reducing STI acquisition by as much as 30%. There is also evidence that behavioral counseling increases condom use and safer sex practices for these groups. Less evidence is available on the effect of counseling for people at average risk, but so far, a significant benefit has not been shown. Potential harms of behavioral counseling include increased sexual activity or perceptions of shame or stigma; however, evidence has not shown this to be case.
How Strong Is the Recommendation to Provide Behavioral Counseling to Reduce STIs?
Given the current evidence, the USPSTF concludes with moderate certainty that behavioral counseling reduces the likelihood of acquiring STIs in sexually active adolescents and in adults at increased risk, resulting in a moderate net benefit.
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1.US Preventive Services Task Force. 聽Behavioral counseling interventions to prevent sexually transmitted infections: US Preventive Services Task Force recommendation statement.聽锘� 听闯础惭础. Published online August 18, 2020. doi: