A Randomized Trial of Clinician-Delivered Interventions Promoting Barrier Contraception for Sexually Transmitted Disease Prevention

• Published in: Sexually transmitted diseases 2005-11, Vol.32 (11), p.672-679
• Main Authors: ARTZ, LYNN, MACALUSO, MAURIZIO, MEINZEN-DERR, JAREEN, KELAGHAN, JOSEPH, AUSTIN, HARLAND, FLEENOR, MICHAEL, HOOK, EDWARD W., BRILL, ILENE
• Format: Article
• Language: English
• Subjects: Administration, Intravaginal; Adult; Anti-Infective Agents, Local - administration & dosage; Biological and medical sciences; Condoms - statistics & numerical data; Contraception, Barrier - methods; Contraception, Barrier - statistics & numerical data; Female; General aspects; Human infectious diseases. Experimental studies and models; Humans; Infectious diseases; Male; Medical sciences; Patient Education as Topic - methods; Physician's Role; Prospective Studies; Safe Sex; Sexual Behavior; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - prevention & control; Treatment Outcome; Videotape Recording
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/01.olq.0000175404.18098.dd

Objective: The objective of this study was to compare 2 interventions promoting condoms and vaginal microbicides to prevent sexually transmitted disease (STD). Study: Women (N = 427) attending an STD clinic were randomly assigned to 2 clinician-delivered interventions and followed up monthly to assess condom/microbicide use and incidence of gonorrhea, chlamydia, and syphilis. Results: During follow up, condom use rates were 69% (enhanced) and 49% (basic) and microbicide use rates were 44% and 29%, respectively. STD rates did not significantly differ between intervention groups. Perfect condom use (regardless of intervention arm) was associated with a 3-fold decrease in STD rates (relative risk [RR], 0.3; 95% confidence interval [CI], 0.1-0.8). Using a vaginal microbicide during ≥50% of the acts of intercourse was associated with reduced STD rates (RR, 0.5; 95% CI, 0.3-1.0) across intervention groups and condom use categories. Conclusions: The enhanced intervention increased use of condoms and vaginal microbicide; however, STD rates did not decrease because a protective effect was seen only among perfect barrier users, and the enhanced intervention only modestly increased perfect use.