Local governments can invest in this strategy using State and Local Fiscal Recovery Funds (SLFRF) from the American Rescue Plan Act (ARPA).

  • This strategy can help residents access health services. The U.S. Department of Treasury has indicated that strategies that help achieve this outcome are eligible for the use of Fiscal Recovery Funds.
  • Investments in this strategy are SLFRF-eligible as long as they are made in qualified census tracts or are designed to assist populations or communities disproportionately impacted by COVID-19.

Program overview

  • Programs to reduce risky behavior and prevent STIs: Behavioral interventions include a range of strategies designed to encourage individuals to make healthier decisions about their health. When used to prevent sexually transmitted infections (STIs), behavioral interventions have been shown to reduce the incidence of STIs, reduce risky sexual behavior, and increase condom use.

  • Improving access to and use of condoms: Barrier methods, and condoms in particular, are an important method of reducing the spread of STIs through sexual contact. To encourage their use, public health departments, nonprofit organizations, and universities can provide condoms for free in public contexts. They can also lead public education campaigns to raise awareness around the importance of condom use.

  • Increasing STI testing and treatment: STI testing is a key strategy to stop the spread of STIs between individuals and ensure that people receive timely treatment. Similarly to condoms, public health departments, nonprofit organizations, and universities can offer STI testing at a free or reduced cost and offer treatment options and guidance for any individuals with positive test results. These services are typically offered in existing school or community spaces to ensure easy access for patients.

  • Offering individual or group counseling: Counseling interventions can help coach individuals through decision-making processes related to healthy sexual behavior. This counseling can be delivered by a counselor, educator, or peer leader who has been trained in STI prevention and healthy behavior strategies. These interventions generally take place in private contexts such as therapy or group therapy sessions, and may be targeted to specific populations (e.g., men who have sex with men).

  • Providing comprehensive sex education: Comprehensive sex education curricula are important for providing children and adolescents with accurate information about STIs and helping them develop a set of skills to make informed, healthy choices around sex and relationships. Sex education typically occurs in classroom contexts.

Evidence and impacts


Ranked as having the highest level of evidence by County Health Rankings and Roadmaps

Multiple studies with rigorous designs demonstrate that behavioral interventions to prevent sexually transmitted infections (STIs) are a well-supported strategy to reduce the incidence of STIs, reduce risky sexual behavior, and increase condom use. 

Best practices in implementation

  • Remove barriers to access: Condom distribution programs, free or reduced cost STI testing opportunities, and counseling programs should be easily accessible to community members. Condom distribution and STI testing sites should be located in places where target populations already frequent, for example in community centers, or in libraries or student unions on college campuses. In order for individuals to participate in regular counseling sessions, the organization should consider transportation and childcare as potential barriers that clients must navigate. As appropriate for the local context, all interventions should consider linguistic accessibility (e.g., having printed materials available in multiple languages).

  • Foster connections to additional health services: Behavioral interventions are only one part of meeting individuals’ sexual health needs. As such, interventions should identify opportunities to connect clients or their target audience to comprehensive health services. For example, condom distribution sites may include a list of STI testing locations. Practitioners performing STI testing may refer individuals to counseling programs. Counselors may in turn encourage participants to take advantage of free condom and STI testing opportunities. And sex education programs can connect youth to STI testing sites, free condoms, relationship counseling, or medical providers who offer other contraceptive methods.

  • Use culturally-adapted interventions: When targeting behavioral interventions toward particular populations, implementing agencies should address issues relevant to that community and tailor delivery approaches accordingly. For example, utilizing lay health advisors (trained peers or community members) can also help to make interventions feel more approachable and welcoming to participants. Using culturally adapted interventions may increase program uptake, retention, and quality of experience.

  • Focus on skill-building: Counseling and sex education interventions should incorporate live demonstrations, role play activities, and skill practice to help participants build concrete skills that help to prevent STIs. For example, participants should learn how to use condoms correctly and how to effectively negotiate safer sex with their partners.

  • Provide extensive staff training: Training and support for facilitators in counseling or sex education settings is essential because of the sensitive and confidential nature of topics related to sexual activity and STIs. Staff should be trained on both informational content and facilitation skills and techniques. This training may occur at conferences or workshops, through training modules, after observations by a supervisor, and more.