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Before AIDS, the role of behavioral interventions in preventing transmission of sexually transmitted diseases was acknowledged in text books and journals but rarely promoted effectively in public health practice. This book addresses the complexities and social contexts of human behaviors which spread STDs, the cultural barriers to STD education, and the sociopolitical nuances surrounding treatment.
Book Synopsis Behavioral Interventions for Prevention and Control of Sexually Transmitted Diseases by : Sevgi O. Aral
Download or read book Behavioral Interventions for Prevention and Control of Sexually Transmitted Diseases written by Sevgi O. Aral and published by Springer Science & Business Media. This book was released on 2008-12-03 with total page 598 pages. Available in PDF, EPUB and Kindle. Book excerpt: Before AIDS, the role of behavioral interventions in preventing transmission of sexually transmitted diseases was acknowledged in text books and journals but rarely promoted effectively in public health practice. This book addresses the complexities and social contexts of human behaviors which spread STDs, the cultural barriers to STD education, and the sociopolitical nuances surrounding treatment.
Before AIDS, the role of behavioral interventions in preventing transmission of sexually transmitted diseases was acknowledged in text books and journals but rarely promoted effectively in public health practice. This book addresses the complexities and social contexts of human behaviors which spread STDs, the cultural barriers to STD education, and the sociopolitical nuances surrounding treatment.
Book Synopsis Behavioral Interventions for Prevention and Control of Sexually Transmitted Diseases by : Sevgi O. Aral
Download or read book Behavioral Interventions for Prevention and Control of Sexually Transmitted Diseases written by Sevgi O. Aral and published by Springer. This book was released on 2008-11-01 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Before AIDS, the role of behavioral interventions in preventing transmission of sexually transmitted diseases was acknowledged in text books and journals but rarely promoted effectively in public health practice. This book addresses the complexities and social contexts of human behaviors which spread STDs, the cultural barriers to STD education, and the sociopolitical nuances surrounding treatment.
One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
Book Synopsis Sexually Transmitted Infections by : National Academies of Sciences, Engineering, and Medicine
Download or read book Sexually Transmitted Infections written by National Academies of Sciences, Engineering, and Medicine and published by . This book was released on 2021-12-24 with total page 750 pages. Available in PDF, EPUB and Kindle. Book excerpt: One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
Book Synopsis Behavioral Interventions for Prevention and Control of Sexually Transmitted Diseases (2007). by :
Download or read book Behavioral Interventions for Prevention and Control of Sexually Transmitted Diseases (2007). written by and published by . This book was released on with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
Book Synopsis Disease Control Priorities, Third Edition (Volume 6) by : King K. Holmes
Download or read book Disease Control Priorities, Third Edition (Volume 6) written by King K. Holmes and published by World Bank Publications. This book was released on 2017-11-06 with total page 506 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexualityâ€"the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.
Book Synopsis The Hidden Epidemic by : Institute of Medicine
Download or read book The Hidden Epidemic written by Institute of Medicine and published by National Academies Press. This book was released on 1997-03-28 with total page 446 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexualityâ€"the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.
From Victorian anxieties about syphilis to the current hysteria over herpes and AIDS, the history of venereal disease in America forces us to examine social attitudes as well as purely medical concerns. In No Magic Bullet, Allan M. Brandt recounts the various medical, military, and public health responses that have arisen over the years--a broad spectrum that ranges from the incarceration of prostitutes during World War I to the establishment of required premarital blood tests. Brandt demonstrates that Americans' concerns about venereal disease have centered around a set of social and cultural values related to sexuality, gender, ethnicity, and class. At the heart of our efforts to combat these infections, he argues, has been the tendency to view venereal disease as both a punishment for sexual misconduct and an index of social decay. This tension between medical and moral approaches has significantly impeded efforts to develop "magic bullets"--drugs that would rid us of the disease--as well as effective policies for controlling the infections' spread. In this 35th anniversary edition of No Magic Bullet, Brandt reflects on recent scholarship, the persistence of sexually transmitted diseases, and the trajectory of the HIV epidemic, as they have informed contemporary conceptions of biomedicine and global health.
Book Synopsis No Magic Bullet by : Allan M. Brandt
Download or read book No Magic Bullet written by Allan M. Brandt and published by Oxford University Press, USA. This book was released on 2020-07-13 with total page 345 pages. Available in PDF, EPUB and Kindle. Book excerpt: From Victorian anxieties about syphilis to the current hysteria over herpes and AIDS, the history of venereal disease in America forces us to examine social attitudes as well as purely medical concerns. In No Magic Bullet, Allan M. Brandt recounts the various medical, military, and public health responses that have arisen over the years--a broad spectrum that ranges from the incarceration of prostitutes during World War I to the establishment of required premarital blood tests. Brandt demonstrates that Americans' concerns about venereal disease have centered around a set of social and cultural values related to sexuality, gender, ethnicity, and class. At the heart of our efforts to combat these infections, he argues, has been the tendency to view venereal disease as both a punishment for sexual misconduct and an index of social decay. This tension between medical and moral approaches has significantly impeded efforts to develop "magic bullets"--drugs that would rid us of the disease--as well as effective policies for controlling the infections' spread. In this 35th anniversary edition of No Magic Bullet, Brandt reflects on recent scholarship, the persistence of sexually transmitted diseases, and the trajectory of the HIV epidemic, as they have informed contemporary conceptions of biomedicine and global health.
This comprehensive, well-illustrated, and easily accessible book documents the latest research outcomes concerning sexually transmitted infections (STIs) and describes important advances in their prevention, diagnosis and treatment. The changes in the epidemiology and clinical aspects of STIs that have occurred over the past decade are fully explored, with special attention to core groups and patients with immunological disorders. The emerging challenges associated with particular sexually transmitted pathogens, including C. trachomatis, N. gonorrhoeae, HPV, and HIV, are identified and discussed. Readers will find detailed information on modern preventive strategies, new laboratory and diagnostic techniques, and a range of innovative treatments, including vaccines, continuous antiretroviral therapy, and new drugs against hepatitis viruses. Attention is also drawn to new directions in biomedical research that promise clinical benefits for the patients and communities. The combination of a detailed clinical and research approach, with emphasis on new knowledge and innovative aspects, ensures that the book will be of value to a wide readership comprising both clinicians and researchers.
Book Synopsis Sexually Transmitted Infections by : Antonio Cristaudo
Download or read book Sexually Transmitted Infections written by Antonio Cristaudo and published by Springer Nature. This book was released on 2020-05-30 with total page 444 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive, well-illustrated, and easily accessible book documents the latest research outcomes concerning sexually transmitted infections (STIs) and describes important advances in their prevention, diagnosis and treatment. The changes in the epidemiology and clinical aspects of STIs that have occurred over the past decade are fully explored, with special attention to core groups and patients with immunological disorders. The emerging challenges associated with particular sexually transmitted pathogens, including C. trachomatis, N. gonorrhoeae, HPV, and HIV, are identified and discussed. Readers will find detailed information on modern preventive strategies, new laboratory and diagnostic techniques, and a range of innovative treatments, including vaccines, continuous antiretroviral therapy, and new drugs against hepatitis viruses. Attention is also drawn to new directions in biomedical research that promise clinical benefits for the patients and communities. The combination of a detailed clinical and research approach, with emphasis on new knowledge and innovative aspects, ensures that the book will be of value to a wide readership comprising both clinicians and researchers.
Book Synopsis Resource Book of the Behavioral Interventions and Research Branch, Division of STD Prevention by : Frederick A. Martich
Download or read book Resource Book of the Behavioral Interventions and Research Branch, Division of STD Prevention written by Frederick A. Martich and published by . This book was released on 2000 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt:
OBJECTIVE: To support an update to the USPSTF's previous recommendation on Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections, we systematically reviewed evidence on behavioral counseling interventions aimed at primary risk reduction for adolescents and adults. DATA SOURCES: Studies from the previous review were evaluated for inclusion, and we performed a comprehensive search of MEDLINE, PubMed (publisher-supplied only), PsycINFO, and the Cochrane Collaboration Registry of Controlled Trials for studies published between January 2013 and June 2018. A research librarian developed and executed the search strategy. STUDY SELECTION: Two researchers independently reviewed 4,649 abstracts and 273 full-text articles against prespecified inclusion criteria, then abstracted data from included studies. English-language controlled clinical trials published after 1999 were included to assess the direct health benefits, intermediate behavioral changes, and potential harms of interventions screening for STI prevention. Trials with control conditions of usual care, no treatment, attention control, or waitlist were included. Included study populations were pregnant and nonpregnant adolescents or adults of any sexual orientation, sexually active or not. Studies conducted in existing social networks (e.g., school classrooms, clubs, churches) were excluded, as were studies of interventions for HIV-positive individuals only. Included interventions included behavioral counseling to reduce STI risk, delivered alone or in combination with other sexual risk-reduction interventions, that were feasible to implement in or refer from primary care. Studies reporting incidence of STI or protective and risky sexual behaviors such as condom use or unprotected intercourse were eligible for inclusion if followup data at least 3 months from baseline were reported. DATA ANALYSIS: Eligible studies assessed to have high risk of bias (e.g., > 40% loss to followup) were excluded for poor quality according to standard USPSTF procedures. Descriptions of the study populations and intervention characteristics were provided for all included studies. The most consistently reported health and behavioral outcomes were analyzed with random effects meta-analysis to calculate pooled intervention effects when data were sufficient. We conducted meta-analyses of STI incidence, condom use, and unprotected intercourse, using the Dersimonian and Laird method or, when fewer than 10 trials were available for pooling, restricted maximum likelihood (REML) models with the Knapp-Hartung correction for small samples. We also examined differences in intervention effects by population, intervention, and study design characteristics, using planned and exploratory metaregression to identify sources of statistical heterogeneity for the main outcome of STI incidence. Finally, funnel plots and Egger tests for small-study effects were generated for all pooled analyses that included 10 or more studies. Using established methods, we assessed the strength of evidence for each key question. RESULTS: We included 39 studies (54 intervention arms) reported in 63 articles (n = 65,888), including 17 new studies not in the previous review. All but five studies were conducted in the United States, and one-third were good-quality trials. Over half of the studies enrolled women or girls only; nearly two-thirds were among adolescents or young adults; and over two-thirds reported that more than half of participants identified as a racial or ethnic minority. The behavioral counseling interventions tested in the trials employed a range of behavior change strategies, with individual or group counseling a component of over two-thirds of the intervention arms. Eight trials tested interventions with low contact times (30 minutes), and high contact time interventions (120 minutes) were included in over half of the included trials. Behavior change techniques based on cognitive behavioral therapy or motivational interviewing were included in over one-third of the interventions, and the content of the interventions was often derived from concepts outlined in behavior change theories. Twenty-one studies reported STI outcomes. Meta-analysis spanning all studies providing adequate data showed that the interventions were associated with one-third lower odds of STI (19 RCTs; n=52,072; odds ratio [OR], 0.66 [95% CI, 0.54 to 0.81]; I2 74%) but statistical and clinical heterogeneity was high among studies. Behavioral outcomes were reported in 34 trials (n = 21,417), but inconsistency in measures used and outcomes reported limited meta-analysis. Eighteen studies reported condom use outcomes (n = 9,205). There was evidence that interventions were associated with increased condom use in meta-analysis of dichotomous reports such as consistent condom use (13 RCTs; n=5,253; odds ratio [OR], 1.31 [95% CI, 1.10 to 1.56]; I2 40%) and greater percentage times condoms were used with sexual intercourse (7 trials; n randomized = 2,920; mean difference [MD], 10.75 [95% CI, 1.01 to 20.50]; I2 79%). For studies reporting counts of unprotected intercourse (i.e., without a condom), measures were inconsistently defined with regard to the types of intercourse (vaginal, anal, any), time period assessed, and partnerships (e.g., any partner, non-primary partner). Behavioral interventions tested in studies that reported this outcome also were associated with a reduction in sexual risk behaviors. Intervention was associated with fewer unprotected sexual acts (14 RCTs; n = 9,183; mean difference [MD], −0.94 [95% CI, −1.40 to −0.48]; I2 16%). There was not evidence of small study effects. Meta-regression to assess potential sources of statistical heterogeneity was limited by correlated study features and the number of studies reporting STI outcomes. There was limited evidence suggesting potentially stronger effects for interventions that included group counseling or higher contact times (> 2 hours). LIMITATIONS: Our search was limited to English-language literature. We excluded trials with active comparators (i.e., comparative effectiveness), conducted in existing social networks (e.g., clubs, schools, workplaces), interventions focused on reducing transmission among HIV-positive individuals, and people very high STI risk behaviors requiring specialized preventive care (e.g., IV drug using, engaged in sex work). Statistical and clinical heterogeneity were high for the included evidence. The direct evidence for STI prevention was consistent and precise, but the diversity of study populations, interventions, and effect sizes contributed to a wide range of effects. Factors explaining the range of effects were difficult to disentangle because they tended to be highly correlated. For behavioral outcomes, the outcomes reported and specific measures used were highly variable, and limited the estimation of pooled effects across studies such that only a subset of fewer than half of the included studies could be combined. Furthermore, self-reported behavioral outcomes, particularly those involving sexual practices, are likely to be affected by social desirability and recall bias. Men, older adults, gay, bisexual, and transgender people were not well-represented in the included study populations. CONCLUSIONS: For individuals at increased risk for STI, there are effective behavioral counseling interventions for reducing STI incidence, by increasing condom use, and reducing sexual risk behaviors. There was no evidence of intervention harms, but few studies reported on potential adverse effects. Research is needed to address gaps in the literature on primary care feasible behavioral interventions that could apply to more heterogeneous populations seen in primary care and to address the needs of specific populations at heightened risk for STI not represented in this body of evidence.
Book Synopsis Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections by : Jillian T. Henderson
Download or read book Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections written by Jillian T. Henderson and published by . This book was released on 2020 with total page 188 pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: To support an update to the USPSTF's previous recommendation on Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections, we systematically reviewed evidence on behavioral counseling interventions aimed at primary risk reduction for adolescents and adults. DATA SOURCES: Studies from the previous review were evaluated for inclusion, and we performed a comprehensive search of MEDLINE, PubMed (publisher-supplied only), PsycINFO, and the Cochrane Collaboration Registry of Controlled Trials for studies published between January 2013 and June 2018. A research librarian developed and executed the search strategy. STUDY SELECTION: Two researchers independently reviewed 4,649 abstracts and 273 full-text articles against prespecified inclusion criteria, then abstracted data from included studies. English-language controlled clinical trials published after 1999 were included to assess the direct health benefits, intermediate behavioral changes, and potential harms of interventions screening for STI prevention. Trials with control conditions of usual care, no treatment, attention control, or waitlist were included. Included study populations were pregnant and nonpregnant adolescents or adults of any sexual orientation, sexually active or not. Studies conducted in existing social networks (e.g., school classrooms, clubs, churches) were excluded, as were studies of interventions for HIV-positive individuals only. Included interventions included behavioral counseling to reduce STI risk, delivered alone or in combination with other sexual risk-reduction interventions, that were feasible to implement in or refer from primary care. Studies reporting incidence of STI or protective and risky sexual behaviors such as condom use or unprotected intercourse were eligible for inclusion if followup data at least 3 months from baseline were reported. DATA ANALYSIS: Eligible studies assessed to have high risk of bias (e.g., > 40% loss to followup) were excluded for poor quality according to standard USPSTF procedures. Descriptions of the study populations and intervention characteristics were provided for all included studies. The most consistently reported health and behavioral outcomes were analyzed with random effects meta-analysis to calculate pooled intervention effects when data were sufficient. We conducted meta-analyses of STI incidence, condom use, and unprotected intercourse, using the Dersimonian and Laird method or, when fewer than 10 trials were available for pooling, restricted maximum likelihood (REML) models with the Knapp-Hartung correction for small samples. We also examined differences in intervention effects by population, intervention, and study design characteristics, using planned and exploratory metaregression to identify sources of statistical heterogeneity for the main outcome of STI incidence. Finally, funnel plots and Egger tests for small-study effects were generated for all pooled analyses that included 10 or more studies. Using established methods, we assessed the strength of evidence for each key question. RESULTS: We included 39 studies (54 intervention arms) reported in 63 articles (n = 65,888), including 17 new studies not in the previous review. All but five studies were conducted in the United States, and one-third were good-quality trials. Over half of the studies enrolled women or girls only; nearly two-thirds were among adolescents or young adults; and over two-thirds reported that more than half of participants identified as a racial or ethnic minority. The behavioral counseling interventions tested in the trials employed a range of behavior change strategies, with individual or group counseling a component of over two-thirds of the intervention arms. Eight trials tested interventions with low contact times (30 minutes), and high contact time interventions (120 minutes) were included in over half of the included trials. Behavior change techniques based on cognitive behavioral therapy or motivational interviewing were included in over one-third of the interventions, and the content of the interventions was often derived from concepts outlined in behavior change theories. Twenty-one studies reported STI outcomes. Meta-analysis spanning all studies providing adequate data showed that the interventions were associated with one-third lower odds of STI (19 RCTs; n=52,072; odds ratio [OR], 0.66 [95% CI, 0.54 to 0.81]; I2 74%) but statistical and clinical heterogeneity was high among studies. Behavioral outcomes were reported in 34 trials (n = 21,417), but inconsistency in measures used and outcomes reported limited meta-analysis. Eighteen studies reported condom use outcomes (n = 9,205). There was evidence that interventions were associated with increased condom use in meta-analysis of dichotomous reports such as consistent condom use (13 RCTs; n=5,253; odds ratio [OR], 1.31 [95% CI, 1.10 to 1.56]; I2 40%) and greater percentage times condoms were used with sexual intercourse (7 trials; n randomized = 2,920; mean difference [MD], 10.75 [95% CI, 1.01 to 20.50]; I2 79%). For studies reporting counts of unprotected intercourse (i.e., without a condom), measures were inconsistently defined with regard to the types of intercourse (vaginal, anal, any), time period assessed, and partnerships (e.g., any partner, non-primary partner). Behavioral interventions tested in studies that reported this outcome also were associated with a reduction in sexual risk behaviors. Intervention was associated with fewer unprotected sexual acts (14 RCTs; n = 9,183; mean difference [MD], −0.94 [95% CI, −1.40 to −0.48]; I2 16%). There was not evidence of small study effects. Meta-regression to assess potential sources of statistical heterogeneity was limited by correlated study features and the number of studies reporting STI outcomes. There was limited evidence suggesting potentially stronger effects for interventions that included group counseling or higher contact times (> 2 hours). LIMITATIONS: Our search was limited to English-language literature. We excluded trials with active comparators (i.e., comparative effectiveness), conducted in existing social networks (e.g., clubs, schools, workplaces), interventions focused on reducing transmission among HIV-positive individuals, and people very high STI risk behaviors requiring specialized preventive care (e.g., IV drug using, engaged in sex work). Statistical and clinical heterogeneity were high for the included evidence. The direct evidence for STI prevention was consistent and precise, but the diversity of study populations, interventions, and effect sizes contributed to a wide range of effects. Factors explaining the range of effects were difficult to disentangle because they tended to be highly correlated. For behavioral outcomes, the outcomes reported and specific measures used were highly variable, and limited the estimation of pooled effects across studies such that only a subset of fewer than half of the included studies could be combined. Furthermore, self-reported behavioral outcomes, particularly those involving sexual practices, are likely to be affected by social desirability and recall bias. Men, older adults, gay, bisexual, and transgender people were not well-represented in the included study populations. CONCLUSIONS: For individuals at increased risk for STI, there are effective behavioral counseling interventions for reducing STI incidence, by increasing condom use, and reducing sexual risk behaviors. There was no evidence of intervention harms, but few studies reported on potential adverse effects. Research is needed to address gaps in the literature on primary care feasible behavioral interventions that could apply to more heterogeneous populations seen in primary care and to address the needs of specific populations at heightened risk for STI not represented in this body of evidence.