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USPSTF 2020 recommends counseling for sexually active adolescents and at-risk adults to prevent STIs (B recommendation)
Question clinique
Should primary care clinicians offer behavioral counseling to sexually active adolescents and at-risk adults to prevent sexually transmitted infections?
L’Essentiel
In this updated 2020 review, the US Preventive Services Task Force (USPSTF) found sufficient evidence to recommend behavioral counseling for the prevention of sexually transmitted infections (STIs) for all sexually active adolescents and adults at increased risk. (B recommendation). Risk factors include history of an STI within the past year, inconsistent use of condoms, multiple sex partners, or a partner at high risk for STIs. Although group or individual counseling lasting more than 2 hours was associated with larger reductions in STI incidence, interventions of less than 30 minutes are also likely effective. Evidence is limited on whether the reduction in STIs persists beyond one year of the counseling. These recommendations are consistent with the 2014 USPSTF recommendations. 1a
Référence
Plan de l'etude: Practice guideline
Financement: Government
Cadre: Population-based
Sommaire
In this updated review, the Task Force found multiple randomized trials of fair to good quality demonstrating that behavioral counseling is associated with reduced STI incidence. Interventions involving more than 120 minutes of counseling, delivered over several sessions have the strongest effect in preventing STIs. Counseling topics include information on common STIs and STI transmission, safe sex practices including training on condom use, problem solving, and negotiation. Although less effective, sessions shorter than 30 minutes delivered at one time may also be effective. The Task Force found limited evidence on the persistence of intervention effects lasting more than 1 year. No evidence of harm from counseling was reported. The CDC, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians recommend routinely obtaining a sexcual history and providing behavioral counseling on prevention of STIs.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Commentaires
counselling
2 hours? most adolescents would not tolerate that. A short carefully worded message, I believe is better.
Practicality of STI education in family practice office.
While agree that STI education is a great thing, the people who need it most are often not the people we see in our offices, i.e. young men. When we see them is usually after the fact, or if they've been contacted by Public Health because they've been named as a contact. When they do show up, that would be a teachable moment, and sometimes just letting them know you're approachable and not going to tell their Mom makes a big difference going forward.
STI counselling
counselling sexually active patients is just good medicine