Counseling prevents STDs in those most at risk

Even a couple brief sessions with a counselor may help prevent cases of HIV and other sexually transmitted diseases among people at greatest risk, new research suggests.

Health officials found that among patients at public STD clinics in five U.S. cities, those who received one-on-one counseling had lower rates of HIV and other sexually transmitted infections over the next year than did patients who received the "educational messages" typically provided with HIV testing.

Most importantly, and unexpectedly, the study authors report, counseling had the biggest effect on the two groups at greatest risk for future STDs - teenagers and patients who had an STD at the start of the study.

Overall, the researchers found, counseling prevented STDs in a number of higher-risk groups that studies have suggested are hard to reach, including injection-drug users and people who have been tested for HIV in the past.

These findings suggest that counseling has the potential to help most STD clinic patients, according to the researchers, led by Omotayo O. Bolu of the Centers for Disease Control and Prevention in Atlanta.

They report the findings in the journal Sexually Transmitted Diseases.

The study also found that brief contact with a counselor - a 20-minute session at the time of an HIV test, and another one when the test results were available - appeared to work as well as four sessions of "enhanced" counseling. Both types of counseling aimed to arm patients with a plan to reduce their STD risk.

The study involved more than 4,300 patients who were followed for a year after receiving either STD counseling or two five-minute talks with a doctor about STD prevention. During the year, 13 percent contracted chlamydia, gonorrhea, syphilis or HIV.

Patients who received counseling, however, were less likely to develop a new STD, particularly when it came to teenagers and individuals who had an STD at the study's start. For these patients, the researchers estimate that counseling prevented eight to 10 percent of STD cases that would otherwise have occurred.

SOURCE: Sexually Transmitted Diseases, August 2004.