title: Does measured behavior reflect STD risk? An analysis of data from a randomized controlled behavioral intervention study. Project RESPECT Study Group.
abstract: BACKGROUND
  Many studies measure sex behavior to determine the efficacy of sexually transmitted disease (STD)/HIV prevention interventions.
  
  
  OBJECTIVE
  To determine how well measured behavior reflects STD incidence.
  
  
  METHODS
  Data from a trial (Project RESPECT) were analyzed to compare behavior and incidence of STD (gonorrhea, chlamydia, syphilis, HIV) during two 6-month intervals.
  
  
  RESULTS
  A total of 2879 persons had 5062 six-monthly STD exams and interviews; 8.9% had a new STD in 6 months. Incidence was associated with demographic factors but only slightly associated with number of partners and number of unprotected sex acts with occasional partners. Many behaviors had paradoxical associations with STD incidence. After combining behavior variables to compare persons with highest and lowest risk behaviors, the STD incidence ratio was only 1.7.
  
  
  CONCLUSIONS
  Behavioral interventions have prevented STD. We found people tend to have safe sex with risky partners and risky sex with safe partners. Therefore, it is difficult to extrapolate the disease prevention efficacy of an intervention from a measured effect on behavior alone.
authors.affiliation: National Center for STD, HIV, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. tap1@cdc.gov
authors.forename: T A
authors.initials: TA
authors.lastname: Peterman
authors.forename: L S
authors.initials: LS
authors.lastname: Lin
authors.forename: D R
authors.initials: DR
authors.lastname: Newman
authors.forename: M L
authors.initials: ML
authors.lastname: Kamb
authors.forename: G
authors.initials: G
authors.lastname: Bolan
authors.forename: J
authors.initials: J
authors.lastname: Zenilman
authors.forename: J M
authors.initials: JM
authors.lastname: Douglas
authors.forename: J
authors.initials: J
authors.lastname: Rogers
authors.forename: C K
authors.initials: CK
authors.lastname: Malotte
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010353:Patient Education as Topic; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology