Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics.
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).
Warner
Lee
L
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia, United States of America.
Klausner
Jeffrey D
JD
Rietmeijer
Cornelis A
CA
Malotte
C Kevin
CK
O'Donnell
Lydia
L
Margolis
Andrew D
AD
Greenwood
Gregory L
GL
Richardson
Doug
D
Vrungos
Shelley
S
O'Donnell
Carl R
CR
Borkowf
Craig B
CB
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