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4/8/14 The U.S. Preventive Services Task Force (USPSTF) issued two draft recommendation statements on the prevention of sexually transmitted infections (STIs). The USPSTF recommends intensive behavioral counseling for all sexually active adolescents and adults at increased risk for STIs. In a related recommendation, the USPSTF recommends screening for chlamydia and gonorrhea in sexually active women age 24 years and younger and in older women who are at increased risk for infection. The Task Force assigned a "B" rating to both recommendations, indicating that the Task Force recommends the services.

Both draft recommendations apply to all sexually active adolescents and adults. The draft recommendation on screening for chlamydia and gonorrhea infections also applies to pregnant women. Age is a strong predictor of risk for both chlamydial and gonococcal infections, with the highest infection rates in women age 20 to 24 years.

The USPSTF's evidence review found that STIs are a significant health concern for many Americans. According to CDC estimates, approximately 20 million cases occur each year, with half of those cases in people ages 15 to 24 years. If untreated, STIs such as gonorrhea and chlamydia, can lead to serious complications including pelvic inflammatory disease, complications in pregnancy, chronic pelvic pain, infertility, cancer, and death.

According to the USPSTF, men with chlamydia or gonorrhea infections are more likely than women to experience symptoms for which they would seek medical attention. As a result of earlier detection and treatment, men with these STIs are less likely than women to develop long-term complications. Subsequently, the Task Force concluded that, for men, there is not enough evidence to determine the effectiveness of screening to prevent chlamydia and gonorrhea.

The USPSTF is an independent panel of non-federal government experts that conduct reviews of scientific evidence of preventive health care services. The USPSTF then develops and publishes recommendations for primary care clinicians and health systems in the form of recommendation statements. As part of their recommendations process, the USPSTF will assign definitions to the services they review based on the certainty that a patient will receive a substantial benefit from receiving the benefit. Services that are graded "A" and "B" are highly recommended and the USPSTF believes there is a high certainty that patient will receive a substantial or moderate benefit. 

Under ACA §1001, all of the recommended services receiving grades of "A" or "B" must be provided without cost-sharing when delivered by an in-network health insurance provider. If the recommendations are finalized with "B" ratings, then screening for gonorrhea and chlamydia for women and behavioral counseling interventions to prevent sexually transmitted infections will be required to be covered without cost-sharing under the ACA.

Comments on the draft recommendation statement on behavioral counseling interventions to prevent sexually transmitted infections at: USPSTF

Comments on both drafts are due May 26, 2014. 

Read the draft recommendation statement on screening for gonorrhea and chlamydia at: http://www.uspreventiveservicestaskforce.org/draftrec2.htm

Read the draft recommendation statement on behavioral counseling interventions to prevent sexually transmitted infections at: http://www.uspreventiveservicestaskforce.org/draftrec3.htm

Learn more about preventive services covered under the ACA at: HHS.Gov