性行为传播感染预防行为咨询干预:美国预防服务工作组推荐声明。

Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections: US Preventive Services Task Force Recommendation Statement.

机构信息

Fairfax Family Practice Residency, Fairfax, Virginia.

Virginia Commonwealth University, Richmond.

出版信息

JAMA. 2020 Aug 18;324(7):674-681. doi: 10.1001/jama.2020.13095.

Abstract

IMPORTANCE

Approximately 20 million new cases of bacterial or viral sexually transmitted infections (STIs) occur each year in the US, and about one-half of these cases occur in persons aged 15 to 24 years. Rates of chlamydial, gonococcal, and syphilis infection continue to increase in all regions. Sexually transmitted infections are frequently asymptomatic, which may delay diagnosis and treatment and lead persons to unknowingly transmit STIs to others. Serious consequences of STIs include pelvic inflammatory disease, infertility, cancer, and AIDS.

OBJECTIVE

To update its 2014 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on the benefits and harms of behavioral counseling interventions for preventing STI acquisition.

POPULATION

This recommendation statement applies to all sexually active adolescents and to adults at increased risk for STIs.

EVIDENCE ASSESSMENT

The USPSTF concludes with moderate certainty that behavioral counseling interventions reduce the likelihood of acquiring STIs in sexually active adolescents and in adults at increased risk, including for example, those who have a current STI, do not use condoms, or have multiple partners, resulting in a moderate net benefit.

RECOMMENDATION

The USPSTF recommends behavioral counseling for all sexually active adolescents and for adults at increased risk for STIs. (B recommendation).

摘要

重要性

每年约有 2000 万例新的细菌性或病毒性性传播感染(STIs)在美国发生,其中约有一半发生在 15 至 24 岁的人群中。所有地区的衣原体、淋病和梅毒感染率都在继续上升。性传播感染通常无症状,这可能会延迟诊断和治疗,并导致感染者无意识地将 STIs 传播给他人。STIs 的严重后果包括盆腔炎、不孕、癌症和艾滋病。

目的

为了更新其 2014 年的建议,美国预防服务工作组(USPSTF)委托对预防 STI 获得的行为咨询干预措施的益处和危害的证据进行了审查。

人群

本建议适用于所有有性行为的青少年以及有更高 STI 风险的成年人。

证据评估

USPSTF 得出结论,有中度确定性的证据表明,行为咨询干预措施可降低有性行为的青少年和有更高 STI 风险的成年人(例如,目前患有 STI、不使用避孕套或有多个性伴侣的人)获得 STI 的可能性,从而产生适度的净收益。

建议

USPSTF 建议对所有有性行为的青少年以及有更高 STI 风险的成年人进行行为咨询。(B 级推荐)。

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