Jeanne Marrazzo, M.D., director of the Division of Infectious Diseases New recommendations published by the U.S. Preventive Services Task Force in the Journal of the American Medical Association support behavioral counseling for sexually active adolescents and adults who are at an increased risk of sexually transmitted infections, including those who have a current STI, do not use condoms or have multiple partners. The recommendations suggest that STI cases can decline if counseling occurs in routine medical checkups.
In an accompanying editorial co-written by Jeanne Marrazzo, M.D., director of the Division of Infectious Diseases at the University of Alabama at Birmingham School of Medicine, notes that the recommended counseling recommendations are “especially important” given that the last decade has brought about an escalating crisis in STI rates. The COVID-19 pandemic has exacerbated the issue, as access to sexual health services has become more challenging for those at risk.
New recommendations suggest that interventions can be 30 minutes or less, and the adoption of technology in behavioral counseling sessions could be beneficial. Furthermore, the editorial focuses on how clinicians must implement the guidance moving forward to ensure success with patients, which involves organizational-level changes to improve the experience for patients seeking counsel.
“A focus on shorter interventions in the current recommendations is key: Even a single STI/HIV prevention counseling session may positively affect behavior,” Marrazzo said. “Important gaps remain in the practice of sexual history taking in clinical care. The time has come to change tactics and provide clinicians with tools to facilitate this critical practice.”
Marrazzo emphasizes in the editorial that sexual history conversations must be performed routinely and nonjudgmentally — particularly in primary care settings — which will help create a safe and confidential setting in which patient and physician can candidly discuss their medical needs. This includes signage about confidentiality and inclusivity practices to create a safe environment.
“These practices help create an environment in which patients not only feel safe raising issues around sexual health but also feel comfortable returning as their sexual health needs evolve.”
The recommendations are updated every six to eight years.