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 A simple video-based waiting room intervention, Safe
in the City, lowers STD incidence among STD clinic
patients by nearly 10%, new CDC data find. In a
controlled trial, the Safe in the City research group
found that patients who were exposed to a 23-minute
HIV/STD prevention video had nearly a 10% reduction in
new infections compared with those who were not exposed
to the video.
The research study to evaluate the Safe in the City
intervention was conducted among patients attending STD
clinics in three US cities. All patients attending those
clinics during a two-year period were included in the
study. The intervention condition (i.e., the Safe in
the City video and movie-style posters) and the
control condition (i.e., standard waiting room
experience) were systematically administered in
alternating 4-week blocks of time. Clinical medical
record data and external county sexually transmitted
infections (STI) surveillance registries were reviewed
to identify and compare incident infections between the
two study groups.
 Of 38,635 patients included, the incident STI rate was
lower in the intervention condition (4.9%) than the
control condition (5.7%). Strong intervention effects
were observed among male patients (13% reduction in STIs)
and those who were diagnosed with an infection at the
beginning of the study (14% reduction).
Safe in the City is a simple video-based
intervention shown in clinic waiting rooms that does not
involve individual or
small-group counseling, additional staffing, or a
specific location to administer counseling.
Safe in the City offers a practical mechanism for
delivering HIV/STD prevention messages at a relatively
low cost and with easy implementation, likely
acceptability, and high likelihood of healthier
behaviors being adopted and sustained over time.
 In this study, simply attending the clinic during times
that the video was showing, without any separate
counseling, was associated with nearly a 10% reduction
in STIs. While the results of this study demonstrate a
relatively modest reduction in STIs compared to more
intensive risk reduction programs, the simplicity and
practicality of showing a video on waiting room
televisions could prove to have significant public
health benefits if adopted by STD clinics nationally.
To obtain more information about the Safe in the City
video and research study, visit
www.safeinthecity.org.
Citation: Warner L, Klausner JD, Rietmeijer CA, Malotte
CK, O’Donnell L, et al. (2008)
Effect of a brief video
intervention on incident infection among patients
attending sexually transmitted disease clinics. PLoS
Med 5(6): e135.
Podcast: Safe in the City Video Intervention
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