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Sponsors and Collaborators: |
Centers for Disease Control and Prevention San Francisco Department of Public Health City of Long Beach Department of Health and Human Services Colorado Department of Public Health and Environment Baltimore City Health Department City of Newark Health Department |
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Information provided by: | Centers for Disease Control and Prevention |
ClinicalTrials.gov Identifier: | NCT00362791 |
The efficacy of counseling to prevent infection with the human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) has not been definitively shown. This multi-center randomized controlled trial (Project RESPECT) sought to compare the effects of 2 interactive HIV/STD counseling interventions with didactic prevention messages typical of current practice.
A total of 5758 STD clinic patients were enrolled from 5 public STD clinics (Baltimore, Md; Denver, Colo; Long Beach, Calif; Newark, NJ; and San Francisco, Calif) between July 1993 and September 1996. Eligible participants were heterosexual, HIV-negative patients aged 14 years or older who came for full STD examinations. Using a block design, participating men and women were randomzied separately to 1 of 3 individual face-to-face interventions.
Arm 1 received "enhanced counseling" consisting of 4 interactive counseling sessions based on the Theory of Reasoned Action and Health Belief Model. Arm 2 received "brief counseling", consisting of 2 interactive risk-reduction sessions based on CDC's client-centered counseling model. Arms 3 and 4 each received 2 brief didactic messages about HIV/STD prevention messages typical of current care at that time. Participants assigned to Arms 1, 2, and 3 were actively followed up after enrollment with questionnaires at 3, 6, 9, and 12 months and STD laboratory examinations and tests at 6 and 12 months. An intent-to-treat analysis was used to compare interventions. Arm 4 participants were followed passively to determine potential effects of active study follow-up. The main outcome measures were self-reported condom use and new diagnoses of STDs (gonorrhea, chlamydia, syphilis, HIV) defined by laboratory tests.
Results: At the 3- and 6-month follow-up visits, self-reported 100% condom use was higher (P<.05) in both the enhanced counseling and brief counseling arms compared with participants in the didactic messages arm. Through the 6-month interval, 30% fewer participants had new STDs in both the enhanced counseling (7.2%; P = .002) and brief counseling (7.3%;P=.005) arms compared with those in the didactic messages arm (10.4%). Through the 12-month study, 20% fewer participants in each counseling intervention had new STDs compared with those in the didactic messages arm (P = .008). Consistently at each of the 5 study sites, STD incidence was lower in the counseling intervention arms than in the didactic messages intervention arm. Reduction of STD was similar for men and women and greater for adolescents and persons with an STD diagnosed at enrollment.
Subset analyses found that
Based on these results, we conclude that short counseling interventions using personalized risk reduction plans can increase condom use and prevent new STDs. Effective counseling can be conducted even in busy public clinics.
Condition | Intervention |
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HIV Sexually Transmitted Diseases |
Behavioral: "Enhanced HIV/STD Counseling:" 4 face-to-face, interctive counseling sessions based on the Theory of
Reasoned Action & Health Belief Model Behavioral: "Brief Counseling" (aka "client-centered counseling"): 2 brief, face-to-face interactive sessions targeted a patient-identified risk behavior Behavioral: "HIV Prevention Education": 2 brief, didactic sessions informing the patient about HIV/STD prevention strategies |
Study Type: | Interventional |
Study Design: | Prevention, Randomized, Single Blind, Active Control, Single Group Assignment, Efficacy Study |
Official Title: | Multicenter Randomized Controlled Trial Evaluating the Efficacy of HIV/STD Prevention Counseling and Testing in Preventing High Risk Behaviors and New Sexually Transmitted Diseases (Project RESPECT) |
Estimated Enrollment: | 6000 |
Study Start Date: | April 2003 |
Estimated Study Completion Date: | July 2005 |
Ages Eligible for Study: | 14 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Exclusion Criteria:
Principal Investigator: | Mary L Kamb, MD, MPH | US Centers for Disease Control and Prevention (CDC) |
Study ID Numbers: | CDC-NCHSTP-1112.1, R30/CCR207113-03, R30/CCR307116-01, R30/CCR807114-04, R33/CCR907111-03, R30/CCR907117-03 |
Study First Received: | August 8, 2006 |
Last Updated: | August 9, 2006 |
ClinicalTrials.gov Identifier: | NCT00362791 History of Changes |
Health Authority: | United States: Federal Government |
voluntary counseling and testing HIV/STD prevention counseling HIV/STD prevention intervention counseling efficacy |
Genital Diseases, Female Virus Diseases HIV Infections |
Acquired Immunodeficiency Syndrome Sexually Transmitted Diseases Genital Diseases, Male |
Genital Diseases, Female Virus Diseases Sexually Transmitted Diseases Genital Diseases, Male Infection |