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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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