Clinical Summary

Sexually Transmitted Infections: Behavioral Counseling

August 18, 2020

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

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Panel 1
What does the USPSTF recommend? For sexually active adolescents and for adults at increased risk: Provide behavioral counseling to prevent sexually transmitted infections (STIs).
Grade: B
To whom does this recommendation apply? All sexually active adolescents and adults at increased risk for STIs
What’s new? This recommendation is consistent with the 2014 USPSTF recommendation. The current recommendation offers a broader range of effective counseling approaches, including those involving less than 30 minutes of counseling.
How to implement this recommendation?  
  1. Assess whether adolescents are sexually active and, for adults, assess risk for STIs. Factors that put a person at increased risk include:
    1. Being diagnosed with an STI within the past year
    2. Not consistently using condoms
    3. Having multiple sex partners or having a partner(s) at high risk for STIs
    4. Belonging to a population that has a high STI prevalence (such as persons seeking STI testing or attending an STI clinic, sexual and gender minorities, persons living with HIV, persons with injection drug use, persons who exchange sex for money or drugs, persons who have recently been in a correctional facility, and some racial/ethnic minority groups)
  2. Provide behavioral counseling to sexually active adolescents and to adults at increased risk:
    1. Deliver counseling in person, refer patients to outside counseling services, or inform patients about media-based interventions
    2. Interventions that include group counseling, involve more than 120 minutes of counseling, and are delivered over several sessions have the strongest effect in preventing STIs
      1. Counseling interventions shorter than 30 minutes delivered in a single session may also be effective
    3. Provide information on common STIs and STI transmission; aim to increase motivation or commitment to safer sex practices; and provide training in condom use, communication about safer sex, problem solving, and other pertinent skills.
What are other relevant USPSTF recommendations? The USPSTF has issued relevant recommendations on the following:
Where to read the full recommendation statement? Visit the USPSTF Web site to read the full recommendation statement. This includes more details on the rationale of the recommendation, including benefits and harms; supporting evidence; and recommendations of others.