The U.S. Preventive Services Task Force urges behavioral counseling, as well as gonorrhea and chlamydia screenings for women, to help prevent sexually transmitted diseases (STDs). This is the agency’s first new STD recommendation since 2007.
According to the Centers for Disease Control and Prevention (CDC), about 20 million STD cases occur in the United States each year. Half of those infections occur in people ages 15 to 24.
If left untreated, STDs, such as gonorrhea and chlamydia, can lead to serious complications. These include pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain, infertility, cancer, and even death.
A study published this year in the Journal of Pediatrics found that only 20 percent of 1,000 teens surveyed in Pennsylvania and New Jersey had their sexual history documented by their pediatrician during a routine checkup. Only 3 percent were tested for gonorrhea and chlamydia and 2 percent were tested for HIV.
In its first recommendation, the agency advises intensive behavioral counseling for all sexually active teens, and for adults at increased risk for any STDs.
Healthline sat down with Task Force co-vice chair Dr. Kirsten Bibbins-Domingo. She said, “This is an important recommendation with regard to prevention. It says that moderate to high intensity counseling about condom use, mutual monogamy, and abSTDnence, are actually effective in preventing STDs. This isn’t just a casual conversation; it’s at least 30 minutes of counseling.”
One study shows that high intensity counseling for two hours can reduce STDs by up to 60 percent, said Bibbins-Domingo. Studies also show that moderate intensity counseling of 30 minutes can reduce STDs by 40 percent.
“Many times clinicians say, we can’t take two hours in the primary care setting to offer counseling. They may refer people to others in the community who offer counseling more routinely, where it can be done effectively,” added Bibbins-Domingo.
Counseling that is successful in preventing STDs includes several approaches:
- providing basic information about the infections and their transmission
- assessing an individual’s risk
- providing condom use education
- providing strategies for communicating with partners about safe sex
In two separate recommendations, the Task Force advises screening for chlamydia and gonorrhea, the most commonly reported STDs. The Task Force recommends these screenings for all sexually active women ages 24 and younger and for older women who are at increased risk for infection.
Chlamydia and gonorrhea screenings are recommended because these infections often cause no symptoms in women. “Women don’t know they have these conditions. That is what underscores the importance for primary care providers to actually screen for these conditions,” explained Bibbins-Domingo.
Complications from these STDs include serious pelvic inflammatory infections and infertility, both of which “can be rather dramatic,” she said.
When asked which women are at increased risk for infection, Bibbins-Domingo said, “If you have a new sexual partner, if your partner has sex with multiple partners, or if you have sex with multiple partners and are not using protection. Age is clearly the biggest factor, with most of these infections happening in the 24 years and under group.”
The Task Force concluded that there is not enough evidence to determine the effectiveness of screening for chlamydia and gonorrhea in men. Unlike women, men with these infections are more likely to experience symptoms, such as painful urination or discharge, for which they would seek medical attention, explained Bibbins-Domingo.
The Task Force also found insufficient evidence that screening men would translate into better health outcomes for women.
Finally, Task Force chair Dr. Michael LeFevre, M.S.P.H., said in a press statement that intensive behavioral counseling can do more than simply help to prevent STDs. “It can also reduce high-risk behaviors and increase protective behaviors,” he said.