A randomized trial of clinician-delivered interventions promoting barrier contraception for sexually transmitted disease prevention.
OBJECTIVE
The objective of this study was to compare 2 interventions promoting condoms and vaginal microbicides to prevent sexually transmitted disease (STD).


METHODS
Women (N = 427) attending an STD clinic were randomly assigned to 2 clinician-delivered interventions and followed up monthly to assess condom/microbicide use and incidence of gonorrhea, chlamydia, and syphilis.


RESULTS
During follow up, condom use rates were 69% (enhanced) and 49% (basic) and microbicide use rates were 44% and 29%, respectively. STD rates did not significantly differ between intervention groups. Perfect condom use (regardless of intervention arm) was associated with a 3-fold decrease in STD rates (relative risk [RR], 0.3; 95% confidence interval [CI], 0.1-0.8). Using a vaginal microbicide during > or =50% of the acts of intercourse was associated with reduced STD rates (RR, 0.5; 95% CI, 0.3-1.0) across intervention groups and condom use categories.


CONCLUSIONS
The enhanced intervention increased use of condoms and vaginal microbicide; however, STD rates did not decrease because a protective effect was seen only among perfect barrier users, and the enhanced intervention only modestly increased perfect use.
Artz
Lynn
L
Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Macaluso
Maurizio
M
Meinzen-Derr
Jareen
J
Kelaghan
Joseph
J
Austin
Harland
H
Fleenor
Michael
M
Hook
Edward W
EW
Brill
Ilene
I
D000282:Administration, Intravaginal; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D017280:Condoms / Q000706:statistics & numerical data; D042121:Contraception, Barrier / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010819:Physician's Role; D011446:Prospective Studies; D021841:Safe Sex; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014743:Videotape Recording
D000891:Anti-Infective Agents, Local