Journal article
Randomized Controlled Trial on the Effectiveness of Counseling Messages for Avoiding Unprotected Sexual Intercourse During Sexually Transmitted Infection and Reproductive Tract Infection Treatment Among Female Sexually Transmitted Infection Clinic Patients
Sexually transmitted diseases, Vol.40(2), pp.105-110
02/01/2013
DOI: 10.1097/OLQ.0b013e31827938a1
PMCID: PMC3811001
PMID: 23321990
Abstract
Background: The effectiveness of counseling messages to avoid unprotected sex during short-term treatment for curable sexually transmitted infections is unknown.
Methods: We randomized 300 female STI clinic patients 18 years or older with cervicitis and/or vaginal discharge in Kingston, Jamaica, in 2010 to 2011, to 1 of 2 counseling messages for their course of syndromic treatment: abstinence only or abstinence backed up by condom use. At a follow-up visit 6 days afterward, we collected vaginal swabs to test for prostate-specific antigen (PSA), a biological marker of recent semen exposure, and administered a questionnaire assessing sexual behavior.
Results: No differences were found in the proportions of women testing positive for PSA at follow-up in the abstinence-plus-condom group (11.9%) and abstinence-only group (8.4%) (risk difference, 3.5; 95% confidence interval, -3.5 to 10.5). There also was no significant difference in reporting of unprotected sex between groups. Reporting a history of condom use before enrollment significantly modified the effect of counseling arm on PSA positivity (P = 0.03). Among those reporting recent condom use, 10.3% in the abstinence-only arm and 4.8% in the abstinence-plus-condom arm tested positive for PSA. Conversely, among those not reporting recent condom use, 6.5% in the abstinence-only arm and 17.3% in the abstinence-plus-condom arm had PSA detected.
Conclusions: We found no evidence to support the superiority of either counseling message. Post hoc analyses suggest that women with recent condom experience may benefit significantly more from abstinence-plus-condom messages, whereas women without such experience may benefit significantly more from abstinence-only messages. Providers should weigh individual condom use history when determining the most appropriate counseling message.
Details
- Title: Subtitle
- Randomized Controlled Trial on the Effectiveness of Counseling Messages for Avoiding Unprotected Sexual Intercourse During Sexually Transmitted Infection and Reproductive Tract Infection Treatment Among Female Sexually Transmitted Infection Clinic Patients
- Creators
- Clive Anderson - Jama Minist Hlth, Epidemiol Res & Training Unit, Comprehens Hlth Ctr, Kingston, JamaicaMaria F. Gallo - Ctr Dis Control & Prevent, Div Reprod Hlth, Atlanta, GA 30341 USATina Hylton-Kong - Jama Minist Hlth, Epidemiol Res & Training Unit, Comprehens Hlth Ctr, Kingston, JamaicaMarkus J. Steiner - Div Clin Sci, Durham, NC USAMarcia M. Hobbs - University of North Carolina at Chapel HillMaurizio Macaluso - Ctr Dis Control & Prevent, Div Reprod Hlth, Atlanta, GA 30341 USAJ. Peter Figueroa - Univ W Indies, Dept Community Hlth & Psychiat, Kingston 7, JamaicaDenise J. Jamieson - Ctr Dis Control & Prevent, Div Reprod Hlth, Atlanta, GA 30341 USAJennifer Legardy-Williams - Ctr Dis Control & Prevent, Div Reprod Hlth, Atlanta, GA 30341 USAJeffrey Wiener - Ctr Dis Control & Prevent, Div Reprod Hlth, Atlanta, GA 30341 USALee Warner - Ctr Dis Control & Prevent, Div Reprod Hlth, Atlanta, GA 30341 USA
- Resource Type
- Journal article
- Publication Details
- Sexually transmitted diseases, Vol.40(2), pp.105-110
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/OLQ.0b013e31827938a1
- PMID
- 23321990
- PMCID
- PMC3811001
- ISSN
- 0148-5717
- eISSN
- 1537-4521
- Number of pages
- 6
- Grant note
- U19AI031496 / NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) U19-AI031496 / Southeastern Sexually Transmitted Infections Cooperative Research Center of the National Institute of Allergy and Infectious Diseases GPO-A-00-05-00022 / Women's Health and Fertility Branch, Division of Reproductive Health, Centers for Disease Control and Prevention
- Language
- English
- Date published
- 02/01/2013
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446541802771
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