Randomized controlled trial on the effectiveness of counseling messages for avoiding unprotected sexual intercourse during sexually transmitted infection and reproductive tract infection treatment among female sexually transmitted infection clinic patients.
Randomized controlled trial on the effectiveness of counseling messages for avoiding unprotected sexual intercourse during sexually transmitted infection and reproductive tract infection treatment among female sexually transmitted infection clinic patients.
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DOI：
10.1097/olq.0b013e31827938a1
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发表时间：
2013-02
影响因子：
3.1
通讯作者：
Warner L
中科院分区：
文献类型：
--
作者：
Anderson C;Gallo MF;Hylton-Kong T;Steiner MJ;Hobbs MM;Macaluso M;Figueroa JP;Jamieson DJ;Legardy-Williams J;Wiener J;Warner L
在可治愈性传播感染的短期治疗期间，咨询信息对避免无保护性行为的有效性尚不清楚。2010年至2011年，我们在牙买加金斯顿的300名18岁或18岁以上患有宫颈炎和/或阴道分泌物的女性STI门诊患者中随机分配了2种咨询信息中的1种，用于其综合征治疗过程：仅禁欲或使用避孕套支持禁欲。在6天后的随访中，我们收集了阴道拭子以检测前列腺特异性抗原（PSA），这是最近精液暴露的生物标志物，并进行了评估性行为的问卷调查。在随访时，禁欲加避孕套组（11.9%）和仅禁欲组（8.4%）的PSA检测阳性女性比例没有差异（风险差，3.5; 95%置信区间，-3.5至10.5）。两组之间无保护性行为的报告也没有显著差异。在入组前报告避孕套使用史显著改变了咨询组对PSA阳性的影响（P = 0.03）。在那些报告最近使用避孕套的人中，仅禁欲组有10.3%，禁欲加避孕套组有4.8%的人PSA检测呈阳性。相反，在那些没有报告最近使用避孕套的人中，仅禁欲组的6.5%和禁欲加避孕套组的17.3%检测到PSA。我们没有发现任何证据支持这两种咨询信息的优越性。事后分析表明，最近使用安全套的妇女可能会从禁欲加安全套的信息中获益更多，而没有这种经验的妇女可能会从禁欲信息中获益更多。提供者在确定最合适的咨询信息时，应权衡个人安全套使用史。
The effectiveness of counseling messages to avoid unprotected sex during short-term treatment for curable sexually transmitted infections is unknown. We randomized 300 female STI clinic patients 18 years or older with cervicitis and/or vaginal discharge in Kingston, Jamaica, in 2010 to 2011, to 1 of 2 counseling messages for their course of syndromic treatment: abstinence only or abstinence backed up by condom use. At a follow-up visit 6 days afterward, we collected vaginal swabs to test for prostate-specific antigen (PSA), a biological marker of recent semen exposure, and administered a questionnaire assessing sexual behavior. No differences were found in the proportions of women testing positive for PSA at follow-up in the abstinence-plus-condom group (11.9%) and abstinence-only group (8.4%) (risk difference, 3.5; 95% confidence interval, −3.5 to 10.5). There also was no significant difference in reporting of unprotected sex between groups. Reporting a history of condom use before enrollment significantly modified the effect of counseling arm on PSA positivity (P = 0.03). Among those reporting recent condom use, 10.3% in the abstinence-only arm and 4.8% in the abstinence-plus-condom arm tested positive for PSA. Conversely, among those not reporting recent condom use, 6.5% in the abstinence-only arm and 17.3% in the abstinence-plus-condom arm had PSA detected. We found no evidence to support the superiority of either counseling message. Post hoc analyses suggest that women with recent condom experience may benefit significantly more from abstinence-plus-condom messages, whereas women without such experience may benefit significantly more from abstinence-only messages. Providers should weigh individual condom use history when determining the most appropriate counseling message.