One STD Counseling Session May Not Be Enough

A study of female military recruits found that screening young women for STDs identifies those who need treatment but does not change their sexual behavior or reduce their odds of re-infection. Females ages 15-24 have the highest rate of STDs, including chlamydia, gonorrhea and trichomoniasis. While experts recommend routine STD screening and one-time counseling as a way to curb the problem, the study suggests that young women need more than these to lower their risk of future infection.

Dr. Loris Y. Hwang and colleagues at the University of California-San Francisco followed 1,712 female Marine recruits with an average age of 18. The women were tested for chlamydia, gonorrhea and trichomoniasis at the start of their 13-week training program. Study participants also completed a questionnaire about their sexual activity during vacation.

At baseline, 12 percent of the recruits tested positive for one of the three STDs, most commonly chlamydia. These women received treatment and underwent a brief counseling session about STDs and safer sex.

The second round of questionnaires revealed 61 percent of the recruits said they had had sex while on vacation. Participants who had tested positive for an STD at the study's start and those who did not were just as likely to report risky sex practices, including casual sex and inconsistent condom use. Despite similar sex behaviors, the women who tested positive for an STD at the beginning of the study were more likely than their peers to test positive for an STD during the second screening round.

The researchers concluded that the "standard-of-care approach" of screening followed by a one-time counseling session does not change women's sexual behavior. The results also suggested that STD "acquisition cannot be reliably predicted by a woman's history of risky sexual behaviors." Counseling tailored to individuals rather than a one-size-fits-all approach could be beneficial, the authors said.

The study, "Sexual Behaviors After Universal Screening of Sexually Transmitted Infections in Healthy Young Women," was published in Obstetrics & Gynecology (2007;109:105-113).

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