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Randomized Controlled Trial of a Safer Sex Intervention for High-Risk Adolescent Girls
Lydia A. Shrier, MD, MPH;
Rose Ancheta, MPH;
Elizabeth Goodman, MD;
Victoria M. Chiou, BA;
Michelle R. Lyden, RN, PNP;
S. Jean Emans, MD
Arch Pediatr Adolesc Med. 2001;155:73-79.
Objective To determine the effect of an individualized safer sex intervention
on condom use and recurrent sexually transmitted disease (STD) among female
adolescents diagnosed as having an STD.
Design Randomized controlled trial.
Setting Urban children's hospital adolescent clinic and inpatient service.
Participants One hundred twenty-three adolescents with cervicitis or pelvic inflammatory
disease.
Intervention Participants completed a questionnaire and then were randomized to receive
standard STD education or to watch a videotape and have an individualized
intervention session. Follow-up questionnaires were completed at 1, 3, 6,
and 12 months. Intervention participants met with an educator at 1, 3, and
6 months to discuss interim sexual history and review the intervention.
Main Outcome Measures Change in self-reported condom use and recurrence of STD. Other self-reported
behaviors, sexual risk knowledge, attitudes toward condoms, and condom use
negotiation skills were also assessed.
Results At 1 month, compared with control participants, intervention participants
had increased sexual risk knowledge and more positive attitudes toward condoms
and tended to use condoms more with a nonmain partner. At 6 months, fewer
intervention participants than controls had sex with a nonmain sexual partner
in the previous 6 months. At 12 months, intervention participants were less
likely to have a current main partner and had a lower rate of recurrent STD
than controls, but these differences were not significant.
Conclusions This individualized safer sex intervention may improve condom use and
decrease the number of partners among adolescent girls who have had an STD.
Studies with larger samples are needed to determine definitive intervention
effects on recurrent STD in this high-risk population.
From the Division of Adolescent/Young Adult Medicine, Children's Hospital,
Harvard Medical School, Boston, Mass.
Corresponding author and reprints: Lydia A. Shrier, MD, MPH, Division
of Adolescent/Young Adult Medicine, Children's Hospital, 300 Longwood Ave,
Boston, MA 02115 (e-mail: shrier{at}a1.tch.harvard.edu).
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