Effect of a Brief Video Intervention on Incident Infection among Patients Attending Sexually Transmitted Disease Clinics

Abstract

BackgroundSexually 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.Methods and FindingsIn 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).ConclusionsShowing 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.Trial registration: http://www.ClinicalTrials.gov (#NCT00137670).

The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative human immunodeficiency virus test in men who have sex with men: systematic and realist reviews and intervention development

“…The reasons for each decision are given in Appendix 3. Articles were excluded for not being a RCT or other suitable study, as specified in our inclusion criteria; not having the sufficient percentage of MSM in the study population; [137][138][139][140][141][142][143][144][145] not including a sufficient percentage of HIV-negative participants; [146][147][148][149][150][151][152][153][154][155][156] or not being an individually focused intervention, instead focusing on groups or structural factors. [157][158][159][160][161][162][163][164][165][166][167] Other reasons for exclusion, such as interventions not being brief, reporting a pilot trial, reporting non-HIV-specific data (e.g.…”

HIV Prevention Interventions to Reduce Racial Disparities in the United States: A Systematic Review

“…Video interventions, although limited due to a lack in interactivity, do offer the benefit of ease of implementation. [39][40][41] Computer technology may overcome some of the limits of video interventions due to its interactive nature; one computerized intervention for STI clinic patients was designed to customized the material provided based on a patient's baseline sexual risk and willingness to change behavior. This program resulted in an increased proportion of subjects reporting consistent condom use at 6 months and decreased proportion with recurrent STIs.…”

Evidence Based Interventions for Preventing HIV Transmission: Commentary on Rotheram-Borus et al. (2009)

“…Safe in the City (Warner et al 2008) is an evidencebased video intervention shown in the waiting rooms of STD clinics. The 23 min video uses professional actors, art direction, cartoon graphics, and a witty theory-based pretested script to keep patients engaged and entertained while they wait for STD diagnostic and treatment services.…”