October 7, 2005
To determine whether behavioral interventions are effective in reducing the rate of sexually transmitted infections (STIs) among genitourinary medicine (GUM) clinic patients, the authors conducted a systematic review and meta-analysis of published articles. Using data from Medline, CINAHL, Embase, PsychINFO, Applied Social Sciences Index and Abstracts, Cochrane Library Controlled Clinical Trials Register and National Research Register (1996-Jan. 2004), the researchers included randomized controlled trials of behavioral interventions if they reported change in STI rates or self-reported sexual behavior. The authors assessed trial quality using the Jadad score and pooled results using random effects meta-analyses where outcomes were consistent across studies.
The investigators included 14 trials, 12 US-based. "Experimental interventions were heterogeneous and most control interventions were more structured than typical UK care," according to the report. The researchers found that eight trials reported data on laboratory-confirmed infections, four of which saw a greater reduction in their intervention groups (with a statistically significant result, p<0.05, in two cases). Seven trials reported consistent condom use, of which six saw a greater increase among their intervention subjects. "Results for other measures of sexual behavior were inconsistent," the study stated. "Success in reducing STIs was related to trial quality, use of social cognition models, and formative research in the target population. However, effectiveness was not related to intervention format or length."
The authors concluded, "While results were heterogeneous, several trials observed reductions in STI rates. The most effective interventions were developed through extensive formative research. These findings should encourage further research in the United Kingdom where new approaches to preventing STIs are urgently required."
Sexually Transmitted Infections
10.05.2005; Vol. 81: P. 386-393; D.J. Ward; B. Rowe; H. Pattison; R.S. Taylor; K.W. Radcliffe