HealthDay News — All sexually active adolescents and adults who are at increased risk for sexually transmitted infections (STIs) should undergo “intensive” behavioral counseling to prevent risk sexual behaviors, according to the United States Preventive Services Task Force (USPSTF). This recommendation statement, published in Annals of Internal Medicine, is a B recommendation.

“Approximately 20 million new cases of STIs occur each year in the United States. Half of these cases occur in persons aged 15 to 24 years. STIs are frequently asymptomatic, which leads persons to unknowingly transmit STIs to others,” wrote Michael L. LeFevre, MD, MSPH, of the USPSTF.

Behavioral counseling can reduce the odds of developing a STI and encourage safe-sex practices, concluded the experts after reviewing previously published studies.

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Interventions ranging in intensity from 30 minutes to two or more hours of contact time are the most beneficial, suggested the researchers. Intensive counseling (two hours or more) was the most effective; moderate-intensity interventions (30 minutes to two hours) were less consistently beneficial; and low-intensity interventions (less than 30 minutes) were the least effective.

Certain approaches to counseling have been successful in preventing STIs, USPSTF found. One effective strategy is providing people with basic information about the different infections and how they are spread. Other beneficial strategies include assessing people’s risk for STIs, teaching them how to use condoms correctly, and providing them with tips on how to communicate with their partner about safe sex.

Primary-care clinicians can provide the counseling or refer patients to trained behavioral counselors. Community organizations, schools, and health departments may also offer risk-reduction counseling.

Many primary-care providers do not routinely provide counseling about sexual activity or contraception during health care visits, USPSTF noted. Stronger links between health-care clinicians and their communities could help improve delivery of this service.


  1. LeFevre M et al. Annals of Internal Medicine. 2014; doi:10.7326/M14-1965