Recommendations to Reduce STDs Focus on Teens, At-Risk Adults

New USPSTF recommendations call for counseling and screening to prevent STDs

(RxWiki News) Sexually transmitted diseases (STDs) continue to be a major health concern. New recommendations call for more measures to address this problem.

Each year, about 20 million new cases of STDs are reported in the US, according to the Centers for Disease Control and Prevention. The National Conference of State Legislatures says that all states have some form of sex education. Half of all new cases of STDs, however, occur among 15- to 24-year-olds.

The US Preventive Services Task Force (USPSTF) has issued new guidelines calling for teens and adults at risk for STDs to receive more counseling and STD screening.

The USPSTF recommendations were written by Elizabeth A. O’Connor, PhD, with the Kaiser Permanente Center for Health Research in Portland, OR, and other health care experts.

The USPSTF assessed the latest data on preventive services. These services include screenings, vaccinations and counseling provided by health care practitioners.

Dr. O’Connor and colleagues reviewed data from 31 studies that addressed the effectiveness of sexual risk-reduction counseling to prevent STDs in adolescents or adults.

They found that “high-intensity” programs reduced STD rates. These programs were over two hours in length. Most high-intensity programs involved group sessions with large educational components. Some were up to 17 hours long.

Moderate-intensity sessions often involved one or two meetings for a total of 45 to 60 minutes of contact. Most low-intensity programs were brief, one-on-one meetings with a counselor or primary care doctor. Some programs only gave out print or digital educational materials.

When the authors pooled results for all the studies, they found that high-intensity counseling after 12 months resulted in a 62 percent reduction in the odds of contracting an STD.

STD prevention education often includes providing basic information about the infections and how they are transmitted. Counselors evaluate a person’s risk, offer condom use instruction and give strategies for talking with partners about safe sex.

Untreated STDs like gonorrhea and chlamydia can lead to major health problems, such as pelvic inflammatory disease, chronic pelvic pain, infertility, cancer and death.

The authors warned that adults at high risk for getting STDs need this type of counseling as well. These adults include those who have had an STD or other infection within the past year, those who have multiple sex partners and those who do not use condoms.

In a separate but related recommendation, the USPSTF said that sexually active women 24 years old and younger should be screened for chlamydia and gonorrhea. Young women have the highest rates of infection from these STDs, the USPSTF noted. Michael LeFevre, MD, a member of the USPSTF, wrote this recommendation.

Older women who have an increased risk for infection — including women who are pregnant — should also be tested for these common STDs, Dr. LeFevre wrote. Older, at-risk women include those who engage in risky behaviors, such as having multiple partners, not using condoms, and having sex for money or drugs.

Some of these STDs may go undiagnosed because they may not show any symptoms.

Dr. LeFevre noted that chlamydia and gonorrhea infection rates among men are highest for those between the ages of 20 and 24. The USPSTF did not recommend for or against screening in men.

“Studies evaluating the effectiveness of screening [men with no symptoms] to reduce the consequences of infection and transmission to sexual partners are needed,” Dr. LeFevre wrote.

Both recommendations were published online Sept. 22 in the Annals of Internal Medicine. The Agency for Healthcare Research and Quality funded the research.

Review Date: 
September 22, 2014