USPSTF Recommends Behavioral Counseling for STI Prevention

The U.S. Preventive Services Task Force (USPSTF) recommends behavioral counseling for sexually active adolescents and for adults with increased sexually transmitted infection (STI) risk. These recommendations form the basis of a draft recommendation statement published online Dec. 17 by the USPSTF.

Jillian T. Henderson, Ph.D., M.P.H., from the Kaiser Permanente Center for Health Research in Portland, Oregon, and colleagues conducted a systematic review to examine the direct health benefits, intermediate behavioral changes, and potential harms of behavioral counseling interventions for STI prevention. Data were included from 39 studies reported in 63 articles, with 65,888 participants. The behavioral counseling interventions employed a range of behavior change strategies.

The researchers found that in a meta-analysis of all studies with adequate data, the behavioral counseling interventions correlated with a reduction in the odds of STI (odds ratio, 0.66), but there was high statistical and clinical heterogeneity. Interventions were associated with increased condom use, including consistent condom use (odds ratio, 1.31) and a greater percentage of times that condoms were used with sexual intercourse. There was also a reduction noted in sexual risk behaviors, including fewer unprotected sexual acts. Based on these findings, the USPSTF recommends behavioral counseling for all sexually active adolescents and adults at increased risk for STI (B recommendation).

The draft recommendation and evidence review have been posted for public comment; comments can be submitted from Dec. 17, 2019, through Jan. 21, 2020.

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