Putting Prevention into Practice
An Evidence-Based Approach
Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections
Am Fam Physician. 2020 Nov 15;102(9):623-624.
Author disclosure: No relevant financial affiliations.
A 24-year-old cisgender woman presents to your primary care clinic for a routine physical examination. Her only medication is an etonogestrel (Implanon) 68-mg implant for birth control. She reports occasional vaping of electronic cigarettes and states that she does not drink alcohol or inject drugs. Her sexual history includes three male partners in the past year and inconsistent condom use. She had Chlamydia trachomatis infection at 17 years of age but has not had any other sexually transmitted infections (STIs), including HIV. She was screened for cervical cancer at 21 years of age without cytologic abnormalities.
Case Study Questions
1. According to the U.S. Preventive Services Task Force (USPSTF) recommendation on preventing STIs, which one of the following factors indicates that this patient is at increased risk of STIs?
A. She is younger than 25 years of age.
B. She uses long-acting, reversible contraception.
C. She was screened for cervical cancer at 21 years of age.
D. She has multiple sex partners.
E. She has a history of electronic cigarette use.
2. Based on the USPSTF recommendation, which one of the following intervention approaches would be a reasonable option to provide to this patient?
A. No interventions are indicated at this time because the USPSTF recommends against providing STI counseling.
B. Provide in-person counseling about STIs, delivered in repeated sessions totaling more than 120 minutes.
C. Provide STI counseling in a single session shorter than 30 minutes once the patient is older than 25 years.
D. Decline to refer the patient to outside STI counseling services or group counseling services because they have been proven to be ineffective.
E. Decline to refer the patient to outside media-based interventions because they have been proven to be ineffective.
3. Which of the following statements about the USPSTF recommendation on behavioral counseling interventions to prevent STIs are correct?
A. Counseling should not include information on common
1. Krist AH, Davidson KW, Mangione CM, et al. Behavioral counseling interventions to prevent sexually transmitted infections: US Preventive Services Task Force recommendation statement. JAMA. 2020;324(7):674–681.
2. Henderson JT, Senger CA, Henninger M, et al. Behavioral counseling interventions to prevent sexually transmitted infections: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2020;324(7):682–699.
This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/sexually-transmitted-infections-behavioral-counseling.
This series is coordinated by Kenny Lin, MD, MPH, deputy editor.
A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.
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