Counseling during Primary Care Visits to Prevent Sexually Transmitted Infections: U.S. Preventive Services Task Force Recommendations. Ann Intern Med. 2008;149:I-36. doi: 10.7326/0003-4819-149-7-200810070-00002
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Published: Ann Intern Med. 2008;149(7):I-36.
The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that makes recommendations about preventive health care.
Sexually transmitted infections (STIs), also known as sexually transmitted diseases (STDs) or venereal diseases, are infections transmitted through sexual contact. Common STIs include syphilis, gonorrhea, chlamydia, herpes, hepatitis C and hepatitis B, human papillomavirus, and HIV. Although great advances have been made in the prevention, detection, and treatment of STIs, these infections remain a common problem in the United States. “Safe sex” practices, such as using condoms, avoiding sexual contact while using alcohol or drugs, and limiting the number of sexual partners, can prevent STIs. The USPSTF wanted to determine whether counseling about safe sex during primary care doctor visits would be an effective way to decrease STIs in the United States.
The USPSTF reviewed published research on counseling in primary care settings to prevent STIs to look at the benefits and harms of screening.
Good-quality studies showed that high-intensity counseling for sexually active adolescents and adults at high risk for STIs reduced the number of STIs at both 6 months and 1 year after counseling. The authors found no studies of STI counseling for adults not at high risk or for non–sexually active adolescents. The potential harms of counseling to the patient are low.
The USPSTF recommends that doctors counsel people at high risk for STIs. People at high risk include all sexually active adolescents, adults with a history of STIs within the past year, and adults with multiple sexual partners.
Because of the lack of evidence, the USPSTF does not recommend for or against STI counseling for non–sexually active adolescents or adults who are not at high risk. However, the USPSTF noted that although the potential harms of counseling are low, the cost of intensive counseling in time and resources is high and these resources might be better spent on types of preventive care that are known to improve health.
The recommendations may change as new studies become available. However, the USPSTF has judged that it would take large, high-quality studies to overturn the recommendation supporting counseling for people at high risk.
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Infectious Disease, Sexually Transmitted Infections, Prevention/Screening.
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