Influencing Risk Behavior of Sexually Transmitted Infection Clinic Visitors: Efficacy of a New Methodology of Motivational Preventive Counseling

Abstract

A quasi-experimental study was conducted at a Dutch sexually transmitted infection (STI) clinic to compare the effects of educational counseling and motivational interviewing (MI)-based HIV/STI counseling on determinants of condom use and partner notification at 6-month follow-up. It also examined the feasibility of MI-based counseling in a busy real-life clinic. The counseling approaches were historically compared: respondents in the control condition were recruited between April and July 2005, those in the experimental condition between September and December 2005. The study involved 428 participants. These were all high-risk clients of the STI clinic. Their mean age was 33.7 years, and 39.6% were female. The study showed that MI-based counseling had a more positive effect on self-efficacy, intentions to use condoms with casual partners, and long-term condom use with steady partners. It had no adversarial outcomes on other social cognitions or behaviors compared to educational counseling. Furthermore, MI-based counseling is experienced as a more respectful and structured way of counseling. MI-based counseling was relatively easily implemented into the current clinic procedures. In addition to the implementation of the training, neither specialized staff nor additional or longer client visits were needed. However, some nurses indicated that the new method required more personal investment and effort. Limitations of the current study are the low response rates, the high educational level of most participants, and the small sample size regarding partner notification. Nonetheless, we conclude that MI-based counseling was a more effective approach to preventive counseling compared to educational counseling and feasible in the busy real-life setting.

Retesting young STI clinic visitors with urogenitalChlamydia trachomatisinfection in the Netherlands; response to a text message reminder and reinfection rates: a prospective study with historical controls

“…Sexual health education and motivational interviewing during first consultation can be effective methods in achieving future condom use 19 20…”

Development of motivational interviewing skills in immunization (MISI): a questionnaire to assess MI learning, knowledge and skills for vaccination promotion

“…[9][10][11][12] MI is a communication technique commonly used for addiction treatment, 13,14 and increasingly so in health promotion, including immunization. 11,12,[15][16][17][18][19][20][21] MI is a patient-centered and directive counseling style, designed to help reinforce a patient's motivation to change a behavior. [22][23][24] Our previous study showed that a short MI-based intervention significantly increases parents' intention to vaccinate their child and significantly improves vaccine coverage of these children.…”

The Feasibility of a Clinic-Based Parent Intervention to Prevent HIV, Sexually Transmitted Infections, and Unintended Pregnancies Among Latino and African American Adolescents

“…Indeed, other clinic-based STI and HIV riskreduction interventions have stressed the importance of respecting existing time constraints in clinic settings. 42,45 Our results also suggest that the intervention should be packaged as an existing service in the clinic that is being offered to families in a spirit of partnership, support, and collaboration. This approach has been used successfully in previous parentbased interventions with ethnic minority families.…”