Behavioral sexual risk reduction counseling in primary care to prevent sexually transmitted infections : an updated systematic evidence review for the U.S. Preventive Services Task Force
We also examined references of other existing systematic reviews; searched Web sites of government agencies, professional organizations, and other organizations for grey literature; and monitored health news Web sites and journal tables of contents to identify potentially eligible trials. Two invest...
Agency for Healthcare Research and Quality
September 2014, 2014
|Collection:||National Center for Biotechnology Information - Collection details see MPG.ReNa|
|Summary:||We also examined references of other existing systematic reviews; searched Web sites of government agencies, professional organizations, and other organizations for grey literature; and monitored health news Web sites and journal tables of contents to identify potentially eligible trials. Two investigators independently reviewed identified abstracts and full-text articles against a set of a priori inclusion and quality criteria. One investigator abstracted data into an evidence table and a second investigator checked these data. We conducted random-effects meta-analyses to estimate the effect of sexual risk reduction counseling on STI incidence and, for adults only, condom use. RESULTS: We included 31 trials reported in 57 publications; 16 (n=56,110) were newly published trials that were not included in the previous review, and 15 trials (n=14,214) were included in the previous review. High-intensity (>2 hours) interventions reduced STI incidence in adolescents and adults.|
Low- and moderate-intensity interventions were generally not effective in adults; however, we identified some promising low- and moderate-intensity approaches. Moderate-intensity interventions may be effective in adolescents, but data were sparse. Pooled effects showed the odds of acquiring an STI were reduced by 62 percent in adolescents (k=5) and 30 percent in adults (k=9) with high-intensity interventions. Reported behavioral outcomes were heterogeneous, and results were most likely to show a benefit with high-intensity interventions at 6 months or less. Most trials targeted populations at increased risk for STIs, as defined by sociodemographic characteristics, history of risky sexual behaviors, or history of an STI. We found no evidence that sexual risk reduction counseling could be harmful.
CONCLUSIONS: High-intensity behavioral sexual risk reduction counseling can reduce the incidence of STIs in primary care and related clinical settings, especially in sexually active adolescents and in adults at increased risk for STIs. Less intensive interventions may also be effective in adolescents, but these data are still sparse. Findings are consistent with and expand upon the previous review on this topic
BACKGROUND: Sexually transmitted infections (STIs) are common and a source of substantial morbidity in the United States. Behavioral sexual risk reduction counseling in primary care may help prevent STIs. PURPOSE: To systematically review evidence on the benefits and harms of primary care-relevant behavioral counseling interventions designed to reduce STIs through reductions in risky sexual behaviors and increased protective sexual behaviors, to aid the U.S. Preventive Services Task Force (USPSTF) in updating its recommendation on this topic. METHODS: Building on a previous review for the USPSTF, we searched a number of databases, including MEDLINE, PubMed, PsycINFO, and the Cochrane Collaboration Registry of Controlled Trials, to identify relevant literature published since the previous review (January 1, 2007 through November 4, 2012).
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