Level III Services: Preventive services that clinicians and care systems could provide to patients, but only after careful consideration of the costs and benefits. Providing these services is left to the judgment of individual care systems, clinicians and their patients.
|The USPSTF recommendations are fully endorsed by the ICSI Preventive Services work group.
||Grade of Recommendation and Level of Certainty as Evaluated by USPSTF|
||Grade of Recommendation:
Level of Certainty:
There is convincing evidence that high-intensity behavioral counseling interventions targeted to sexually active adolescents and adults at increased risk for STIs reduce the incidence of STIs. These results were found 6 and 12 months after counseling took place.
The USPSTF has identified the absence of studies and evidence on behavioral counseling interventions directed toward adults not at increased risk for STIs and non-sexually-active adolescents as a critical gap in the literature.
No evidence of significant behavioral or biological harms resulting from behavioral counseling about risk reduction has been found. The USPSTF concluded that the potential harms of counseling are no greater than small.
The USPSTF concludes that there is moderate certainty that high-intensity behavioral counseling has a moderate net benefit for sexually active adolescents and for adults who are at increased risk for STIs.
The USPSTF concludes that the evidence is currently insufficient to assess the balance of benefits and harms of behavioral counseling for non-sexually active adolescents and for adults who are not at increased risk for STIs.
Assessment of Risk:
All sexually active adolescents are at increased risk for STIs and should be counseled. Other risk groups that have been included in counseling studies include adults with current STIs or other infections within the past year, adults who have multiple sex partners, and adults who do not consistently use condoms.
Clinicians should be aware of populations with a particularly high prevalence of STIs. African Americans have the highest STI prevalence of any racial/ethnic group, and STI prevalence is higher in American Indians, Alaska Natives and Latinos than in white persons. Increased STI prevalence rates are also found in men who have sex with men (MSM), persons with low incomes living in urban settings, current or former inmates, military recruits, persons who exchange sex for money or drugs, persons with mental illness or a disability, current or former intravenous drug users, persons with a history of sexual abuse, and patients at public STI clinics.”