title: Changes in sexual behavior and STD prevalence among heterosexual STD clinic attendees: 1993-1995 versus 1999-2000.
abstract: 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.
authors.affiliation: Division of STD Prevention, CDC, Atlanta, Georgia 30333, USA. clindsey@cdc.gov
authors.forename: Catherine Lindsey
authors.initials: CL
authors.lastname: Satterwhite
authors.forename: Mary L
authors.initials: ML
authors.lastname: Kamb
authors.forename: Carol
authors.initials: C
authors.lastname: Metcalf
authors.forename: John M
authors.initials: JM
authors.lastname: Douglas
authors.forename: C Kevin
authors.initials: CK
authors.lastname: Malotte
authors.forename: Sindy
authors.initials: S
authors.lastname: Paul
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Peterman
mesh_terms: 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