Doctors should talk about risky sex to teens, guidelines say

Cases of sexually transmitted infections in the U.S. could be significantly reduced if younger patients got counseling about risky behavior during regular medical checkups, an influential panel of health experts says in its latest guidance.

In a statement issued Tuesday, the U.S. Preventive Services Task Force recommends behavioral counseling for all sexually active adolescents, as well as for adults at high risk for STIs. Of the estimated 20 million new STIs every year in the U.S., 50 percent are among young people ages 15 to 24. At the same time, rates of the sexually transmitted diseases chlamydia, gonorrhea and syphilis have reached all-time highs in the U.S., according to the most recent report from the Centers for Disease Control and Prevention.

Clearly, something needs to be done.

"Counseling interventions can actually potentially reduce the rate of sexually transmitted infection by about a third," said Dr. Melissa Simon, a task force member who is a professor of obstetrics and gynecology at the Northwestern University Feinberg School of Medicine. "That's astonishing"

The new guidelines, which are updated every six to eight years, shorten the time doctors, nurses or other health workers are advised to spend with patients discussing risky sex behavior.

Previously, the guidelines recommended group counseling or multiple sessions lasting as long as two hours. The new recommendation cuts the intervention to 30 minutes or less, which can be completed in a single session. Videos, texts messages or websites that give instructions about condom use and how infections are spread or offer motivation for safer sex practices can be visited on the patient's own time, outside the medical office.

"Using behavioral interventions could be a good way to reverse the increase in sexual infections that we've seen," said Dr. Jason Zucker, an infectious diseases expert at the Columbia University Irving Medical Center.

The guidelines target sexually active teenagers or adults who are more likely to get STIs. That's defined as having had an STI within the past year, not regularly using condoms, having multiple sex partners or being part of a community with high STI rates.

The new guidelines are a step in the right direction, but risky behaviors aren't always obvious or just about multiple partners, said Dr. Edward Hook, a professor of medicine at the University of Alabama at Birmingham.

"Over half of women who get chlamydia infections in the United States have only had a single sexual partner in the last three to six months," he said.

If untreated, STIs can cause infertility, cancer or AIDS.

"The topic should not be as taboo as it tends to be" Simon said.