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New counseling recommendation to prevent STIs.

For decades, we've known that sexually transmitted infections (STIs) are a problem for women, but tools that women can use to protect themselves from infection are still limited and strategies to improve screening and II treatment have had limited success. At last, the U.S. Preventive Services Task Force (USPSTF)--the nation's leading expert panel in preventive and primary medicine--has released recommendations about how health care providers can best address this pressing concern. The recommendations are based on evidence showing that high-intensity behavioral counseling can help reduce infections among sexually active adolescents and adults at increased risk of STIs. (1)

Despite advances in screening, diagnosis, and treatment of STIs including HIV/AIDS and human papillomavirus (HPV), a high burden of disease continues to affect both individuals and the health care system. Untreated STIs can harm the immune system and cause a wide array of negative outcomes including cancer, damaged reproductive organs, infertility, brain damage, and death. Over 19 million new cases of STIs are diagnosed every year, half of which occur in individuals aged 15-24; about one-quarter of U.S. women between 14-19 have at least one STI. (2) Clearly, preventing STIs is in everyone's best interests.

The USPSTF analyzes scientific research to assess what preventive services should be incorporated into primary medical care; its recommendations are considered to be the gold standard for clinical preventive services and are adopted by many providers. In the new report, USPSTF recommends high-intensity behavioral counseling for all sexually active adolescents and adults at risk for STIs--specifically, anyone who has had an STI in the last year, has multiple sexual partners, is in non-monogamous relationships, and/or lives in communities with high STI rates. High-intensity behavioral counseling consists of multiple sessions with content that includes education, skills-building, and support for risk reduction behavior. The multiple counseling sessions reinforce the importance of protecting one's sexual health and has been shown to help prevent STIs. (3) (While the USPSTF was unable to assess potential benefits of behavioral counseling for those who are not at-risk, it noted that the potential harm of counseling this population is likely to be quite small.)

The NWHN supports this recommendation and encourages health care providers to incorporate high-intensity behavioral STI counseling into practice. It is important for women to be screened and counseled annually for STIs and encouraged to gain the skills and information needed to protect themselves. If targeted screenings such as those recommended by USPSTF could reach all high-risk women annually, it is estimated that the rate of STIs in the U.S. could be reduced by as much as 35 percent--saving lives and enhancing health. (4)

For more information on the recommendation and preventive services, see the current edition of the Guide to Clinical Preventive Services on the USPSTF website: http://www.ahrq.gov/clinic/uspstfab.htm.

REFERENCES

(1) Center for Disease Control and Prevention (CDC), STD Facts: HPV Infection Fact Sheet, Atlanta, GA: CDC, 20008. Retrieved 4/19/09 from http://www.cdc.gov/STD/HPV/STDFact-HPV.htm.

(2) U.S. Preventive Service Task Force, "Behavioral counseling to prevent sexually transmitted infections: U.S. preventive services task force recommendation statement," Ann Internal Med 2008(149):491-496. Retrieved 4/10/09 from: http://www.ahrq.gov/clinic/uspstf08/ sti/stirs.pdf. See also U.S. Preventive Services Task Force, About USPSTF, Rockville, MD: USPSTF, 2009. Retrieved 4/10/09 from: http://www.ahrq.gov/clinic/uspstfab.htm.

(3) Perterman TA, Tian LH, Metcalf CA, et al., "High incidence of new sexually transmitted infections in the year following a sexually transmitted infection: A case for rescreening," American College of Physicians 2006; 145(8):564-572. Retrieved 4/19/09 from: http://www.annals.org/cgi/content/abstract/145/8/564.

(4) Low N, Broutet N, Adu-Sarkodie Y, et al., "Global control of sexually transmitted infections," Lancet 2006; 368, 2001-2016. Retrieved 4/19/09 from: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1B-4MG1WC2-H&. _user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version =1&_urlVersion=0&_userid=10&md5=123589579c396f19b49ee8e9bbe8def2.

Theresa Watts is an RN and MPH student at George Washington University and a NWHN volunteer
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Author:Watts, Theresa
Publication:Women's Health Activist
Date:Jul 1, 2009
Words:690
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