title: Evaluation of a cognitive-behavioral, group, randomized controlled intervention trial to prevent sexually transmitted infections and unintended pregnancies in young women.
abstract: BACKGROUND
  Few cognitive-behavioral interventions have focused on preventing sexually transmitted infections (STIs) and unintended pregnancies (UPs) in young, sexually active women in a single study. Military recruit training provides a well-defined, national, nonclinic sample in which to evaluate such an intervention.
  
  
  METHODS
  All female Marine recruits (N=2,288) in training were approached. Of these, 2,157 (94.3%) voluntarily agreed and were randomly assigned, by platoons, to participate in cognitive-behavioral interventions to prevent STIs or UPs or to prevent physical training injuries and cancer. Participants completed self-administered questionnaires and were screened for pregnancy, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis at baseline and, on average, 1 and 14 months postintervention.
  
  
  RESULTS
  A higher proportion of the control group had a postintervention STI or UP [odds ratio (OR)=1.41, 95% confidence interval (CI)=1.01-1.98]. Among participants who had no history of STIs or pregnancy, but who engaged in risky sexual behaviors just before recruit training, the control group was more likely to acquire a postintervention STI (OR=3.24, CI=1.74-6.03). Among participants who were not sexually experienced at baseline, the control group was more likely to have casual (OR=2.05, 95% CI=1.04-4.08) and multiple (OR=1.87, 95% CI=1.01-3.47) sexual partners postintervention.
  
  
  CONCLUSIONS
  This randomized controlled trial indicates that cognitive-behavioral interventions are effective for reducing behavioral risk and preventing STIs and UPs in young, sexually active women who are not seeking health care.
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California, San Francisco, CA 94143-0503, USA. boyer@itsa.ucsf.edu
authors.forename: Cherrie B
authors.initials: CB
authors.lastname: Boyer
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Shafer
authors.forename: Richard A
authors.initials: RA
authors.lastname: Shaffer
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Brodine
authors.forename: Lance M
authors.initials: LM
authors.lastname: Pollack
authors.forename: Kelli
authors.initials: K
authors.lastname: Betsinger
authors.forename: Y Jason
authors.initials: YJ
authors.lastname: Chang
authors.forename: Heidi S
authors.initials: HS
authors.lastname: Kraft
authors.forename: Julius
authors.initials: J
authors.lastname: Schachter
mesh_terms: D000328:Adult; D017280:Condoms; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006801:Humans; D017533:Marital Status; D008889:Military Personnel; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D015397:Program Evaluation / Q000706:statistics & numerical data*; D012307:Risk Factors; D012736:Sex Education / Q000379:methods* / Q000592:standards; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D012959:Socioeconomic Factors