Document Detail


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.
MedLine Citation:
PMID:  23321990     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Clive Anderson; Maria F Gallo; Tina Hylton-Kong; Markus J Steiner; Marcia M Hobbs; Maurizio Macaluso; J Peter Figueroa; Denise J Jamieson; Jennifer Legardy-Williams; Jeffrey Wiener; Lee Warner
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Sexually transmitted diseases     Volume:  40     ISSN:  1537-4521     ISO Abbreviation:  Sex Transm Dis     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-16     Completed Date:  2013-07-09     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  7705941     Medline TA:  Sex Transm Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105-10     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Ambulatory Care
Biological Markers / analysis
Coitus
Condoms / utilization*
Directive Counseling*
Female
Humans
Jamaica / epidemiology
Prostate-Specific Antigen / analysis*
Questionnaires
Reproductive Tract Infections* / epidemiology
Risk Factors
Risk-Taking
Semen / chemistry
Sexual Abstinence* / statistics & numerical data
Sexually Transmitted Diseases / epidemiology,  prevention & control*
Treatment Outcome
Unsafe Sex / prevention & control*,  statistics & numerical data*
Vagina / chemistry
Vaginal Smears
Grant Support
ID/Acronym/Agency:
U19 AI031496/AI/NIAID NIH HHS; U19-AI031496/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; EC 3.4.21.77/Prostate-Specific Antigen
Comments/Corrections
Comment In:
Sex Transm Dis. 2013 Feb;40(2):111-2   [PMID:  23321991 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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