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Behavioral counseling prevents sexually transmitted infections

Evidence suggests that behavioral counseling in sexually transmitted infections (STIs) clinics and primary care offices reduces STIs in “at-risk” adults and adolescents.

First, the details.

  • Reviewers included 21 studies of behavioral counseling that would be feasible in primary care practice.
  • All studies included a true control group.
  • “At risk” was defined on sociodemographics and individual patient characteristics.
  • “Counseling” ranged from low intensity (eg, distribution of self-help materials) to high intensity (eg, up to 10 counseling sessions).

And, the results.

  • Adults and sexually active adolescents receiving multiple counseling sessions had a modest reduction in STIs at 12 months.
    • Eyeballing the results, it looks like about a 30% reduction at best.
  • Counseling increased adherence to treatment recommendations among women in STI clinics and the use of contraceptives by male adolescents.
  • There was a decrease in nonsexual risky behavior and pregnancy in sexually active female adolescents.
  • No behavioral or biological harm was found with counseling.

The bottom line?
Just passing out brochures is not going to lower STIs.

The authors concluded, “Behavioral counseling interventions with multiple sessions conducted in STI clinics and primary care effectively reduces STI incidence in ‘at-risk’ adult and adolescent populations.”

It’s not known if this approach would be useful in lower-risk groups.

Based on these findings, the US Preventive Services Task Force (USPSTF) recommends “high-intensity behavioral counseling for all sexually active adolescents and for adults at increased risk for STIs.”

The USPSTF is part of the US Department of Health and Human Services. It conducts “impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications. Its recommendations are considered the ‘gold standard’ for clinical preventive services.”

10/7/08 09:44 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.