title: Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics.
abstract: BACKGROUND
  Sexually transmitted disease (STD) prevention remains a public health priority. Simple, practical interventions to reduce STD incidence that can be easily and inexpensively administered in high-volume clinical settings are needed. We evaluated whether a brief video, which contained STD prevention messages targeted to all patients in the waiting room, reduced acquisition of new infections after that clinic visit.
  
  
  RESULTS
  In a controlled trial among patients attending three publicly funded STD clinics (one in each of three US cities) from December 2003 to August 2005, all patients (n = 38,635) were systematically assigned to either a theory-based 23-min video depicting couples overcoming barriers to safer sexual behaviors, or the standard waiting room environment. Condition assignment alternated every 4 wk and was determined by which condition (intervention or control) was in place in the clinic waiting room during the patient's first visit within the study period. An intent-to-treat analysis was used to compare STD incidence between intervention and control patients. The primary endpoint was time to diagnosis of incident laboratory-confirmed infections (gonorrhea, chlamydia, trichomoniasis, syphilis, and HIV), as identified through review of medical records and county STD surveillance registries. During 14.8 mo (average) of follow-up, 2,042 patients (5.3%) were diagnosed with incident STD (4.9%, intervention condition; 5.7%, control condition). In survival analysis, patients assigned to the intervention condition had significantly fewer STDs compared with the control condition (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.84 to 0.99).
  
  
  CONCLUSIONS
  Showing a brief video in STD clinic waiting rooms reduced new infections nearly 10% overall in three clinics. This simple, low-intensity intervention may be appropriate for adoption by clinics that serve similar patient populations.
  
  
  BACKGROUND
  http://www.ClinicalTrials.gov (#NCT00137670).
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia, United States of America.
authors.forename: Lee
authors.initials: L
authors.lastname: Warner
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
authors.forename: Cornelis A
authors.initials: CA
authors.lastname: Rietmeijer
authors.forename: C Kevin
authors.initials: CK
authors.lastname: Malotte
authors.forename: Lydia
authors.initials: L
authors.lastname: O'Donnell
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Margolis
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Greenwood
authors.forename: Doug
authors.initials: D
authors.lastname: Richardson
authors.forename: Shelley
authors.initials: S
authors.lastname: Vrungos
authors.forename: Carl R
authors.initials: CR
authors.lastname: O'Donnell
authors.forename: Craig B
authors.initials: CB
authors.lastname: Borkowf
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000554:Ambulatory Care Facilities; D001296:Audiovisual Aids; D019411:Clinical Laboratory Techniques; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D013997:Time Factors; D014741:Video Recording