Culturally Relevant Behavioral Intervention Dramatically Reduces STDs

Women in the study were being treated for a sexually transmitted disease (STD) such as gonorrhea, chlamydial infection, syphilis or trichomoniasis. The study focused on minority women because they are disproportionately affected by STDs, including AIDS.

The Jan. 14 issue of The New England Journal of Medicine contains a report on the study authored by Rochelle N. Shain, Ph.D., and others from the departments of obstetrics and gynecology and microbiology at the University of Texas Health Science Center in San Antonio and the San Antonio Health Department.

"This study confirms that sexually transmitted diseases can be prevented through behavioral intervention," says Anthony S. Fauci, M.D., NIAID director. "In the absence of effective vaccines, this type of intervention is our best hope to control the STD/HIV epidemic today."

"The culturally relevant intervention was designed to help women recognize that they are susceptible to sexually transmitted diseases, including AIDS, and can do something about it," says Penelope J. Hitchcock, D.V.M., chief of the sexually transmitted diseases branch in NIAID's Division of Microbiology and Infectious Diseases. Participants were encouraged to commit to behavior change and acquire the necessary skills, including negotiating safer sex options, to effect change.

The controlled, randomized study required approximately half of the 424 Mexican-American and 193 African-American women to attend three- to four-hour group counseling sessions once a week for three weeks. The remaining women in the study received standard individual counseling, generally a one-time 15-minute session. All of the women received medical treatment for STDs and were screened for new infections at six and 12 months after the study began.

Compared with the control group, women who participated in the intervention were less likely to have had more than one sex partner and to have had sex with untreated or incompletely treated partners. They also were less likely to have had more than a few sexual acts without condoms. The infection rate for chlamydial infection and gonorrhea among women assigned to the intervention was 34 percent less than that of the control group at six months (11.3 percent vs. 17.2 percent); 49 percent less between six and 12 months (9.1 percent vs. 17.7 percent); and 38 percent less during the entire study (16.8 percent vs. 26.9 percent). Interventions that prevent STDs may also help prevent sexually acquired HIV infection.

Other authors of the study were Jeanna M. Piper, M.D., Sondra T. Perdue, Dr.P.H., and Jane Dimmitt Champion, Ph.D., of the University of Texas Heal