Changes in sexual behavior and STD prevalence among heterosexual STD clinic attendees: 1993-1995 versus 1999-2000.
OBJECTIVE
To examine trends in sex behaviors and STD prevalence over time among heterosexual STD clinic populations from 3 urban STD clinics in the United States.


METHODS
Cross-sectional analysis comparing baseline data on risk (self-reported) and STDs (laboratory defined) from 2 randomized controlled trials evaluating counseling efficacy conducted about 5 years apart, Project RESPECT (1993-1995) and RESPECT-2 (1999-2000).


RESULTS
The participants from RESPECT (n = 2457) and RESPECT-2 (n = 3080) were demographically similar. However, the proportion of participants reporting any unprotected anal sex was much higher in RESPECT-2 (women: 7% vs. 18%; men: 7% vs. 17%). Also, substantially more participants reported a new sex partner in RESPECT-2 (women: 43% vs. 61%; men: 54% vs. 72%). In addition, more women reported 2 or more partners (37% vs. 48%) and a partner with another concurrent sex partner (19% vs. 32%). Slightly more women and men in RESPECT-2 reported 2 protective behaviors, having an HIV test and any condom use; however, consistent condom use did not differ. Conversely, the proportion of participants with bacterial STDs (chlamydia, gonorrhea, or syphilis) was much lower in RESPECT-2 (women: 24% vs. 18%; men: 38% vs. 24%).


CONCLUSIONS
Despite substantial promotion of safer sex behaviors over the past decade, many risk behaviors were stable over time, and some behaviors, such as unprotected anal sex, appeared substantially higher. Even in the absence of widespread behavior change, the prevalence of common bacterial STDs appeared to have decreased appreciably.
Satterwhite
Catherine Lindsey
CL
Division of STD Prevention, CDC, Atlanta, Georgia 30333, USA. clindsey@cdc.gov
Kamb
Mary L
ML
Metcalf
Carol
C
Douglas
John M
JM
Malotte
C Kevin
CK
Paul
Sindy
S
Peterman
Thomas A
TA
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D017280:Condoms; D003430:Cross-Sectional Studies; D005260:Female; D020010:Heterosexuality; D006801:Humans; D008297:Male; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology