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Hot Topics in Sexually Transmitted Infections and Associated Conditions

(Published November 2013)

Counseling Patients about Sexually Transmitted Infections

  • The National Network of STD/HIV Prevention Training Centers recommends these steps for providing patient-centered counseling on STIs:7
    • Speak with, rather than to, the patient.
    • Ask questions that focus on issues that the patient identifies, accept the patient’s ideas about changing his or her behavior, and acknowledge the patient’s feelings as important.
    • Maintain a nonjudgmental attitude.
    • Use open-ended questions (e.g., “What are your concerns about condom use?” rather than “Are you concerned about asking your partner to use condoms?”).
    • Support positive risk-reduction behaviors the patient has taken.
    • Assist the patient in identifying barriers to risk reduction.
    • Set a realistic risk-reduction plan, with steps that are acceptable to the patient, explicit, and achievable.
    • Offer options, not directives.
  • Other steps include the following:
    • Provide key counseling messages about specific STIs as relevant, and provide basic information about STIs. (For downloadable fact sheets about specific STIs in English and Spanish, see www.cdc.gov/std/healthcomm/fact_sheets.htm.)
    • Focus on the positive aspects of sexual health, and share counseling messages that normalize sexual health.
    • Encourage the evaluation of sex partners, and arrange for therapy of partners with treatable STIs.
    • Do not make assumptions about a patient’s sexual orientation.
  • Counseling tips for the adolescent patient8 include the following:
    • Become familiar with slang terms that adolescents use to talk about sex.
    • Dispel common myths, such as “only vaginal sex spreads STIs” and “the pill protects against STIs.”
    • Address STIs and their importance to sexual health during annual well-adolescent exams, sports physicals, and evaluations for amenorrhea or dysmenorrhea, and include evaluation for possible STIs.
    • Consider talking about sexual health in general with the adolescent with his or her parent present, but then meet with the adolescent alone to discuss sexual habits, activity, and preferences.