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Publication Type
Journal Article
Author, Analytic
Anderson, Clive; Gallo, Maria F; Hylton-Kong, Tina; Steiner, Marcus J; Hobbs, Marcia M; Macaluso, Maurizio; Figueroa, J.Peter; Jamieson, Denise J; Legardy-Williams, Jennifer; Wiener, Jeffrey; Warner, Lee
Author Affiliation, Ana.
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Article Title
Randomized controlled trial on the effectiveness of counseling messages for avoiding unprotected sexual intercourse during STI and reproductive tract infection treatment among female STI clinic patients
Medium Designator
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Connective Phrase
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Journal Title
Sexually Transmitted Diseases
Translated Title
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Reprint Status
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Date of Publication
2013
Volume ID
40
Issue ID
2
Page(s)
105-110
Language
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Connective Phrase
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Location/URL
https:; www.ncbi.nlm.nih.gov/pmc/articles/PMC3811001/
ISSN
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Notes
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Abstract
BackgroundThe effectiveness of counseling messages to avoid unprotected sex during short-term treatment for curable sexually transmitted infections is unknown.MethodsWe 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.ResultsNo 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.ConclusionsWe 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.....
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