Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics

Lee Warner, Jeffrey D Klausner, Cornelis A Rietmeijer, C Kevin Malotte, Lydia O'Donnell, Andrew D Margolis, Gregory L Greenwood, Doug Richardson, Shelley Vrungos, Carl R O'Donnell, Craig B Borkowf, Safe in the City Study Group, Lee Warner, Andrew Margolis, Jocelyn Patterson, Craig Borkowf, David Purcell, Ann O'Leary, Fan Zhang, Terry Wang, Mary Neumann, Kashif Iqbal, Bob Byers, Gale Burstein, Thomas Peterman, Catherine Lindsey Satterwhite, Cornelis Rietmeijer, John Douglas, Sheana Bull, Doug Richardson, Mark Foster, Stuart Cooper, Julie Caine, Rebecca Rothbard, Terry Sapp-Jones, Lesley Brooks, Lydia O'Donnell, Alexi San Doval, Athi Myint-U, Richard Duran, Carl O'Donnell, Kevin Malotte, Shelley Vrungos, Nettie DeAugustine, Chris Kau, Inez Denson, Marina Ohlson Smorick, Ann Marie Bernhard, Jeffrey Klausner, Gregory Greenwood, Carolyn Hunt, Elizabeth Varela, Kevin Filocamo, David Bandy, Lee Warner, Jeffrey D Klausner, Cornelis A Rietmeijer, C Kevin Malotte, Lydia O'Donnell, Andrew D Margolis, Gregory L Greenwood, Doug Richardson, Shelley Vrungos, Carl R O'Donnell, Craig B Borkowf, Safe in the City Study Group, Lee Warner, Andrew Margolis, Jocelyn Patterson, Craig Borkowf, David Purcell, Ann O'Leary, Fan Zhang, Terry Wang, Mary Neumann, Kashif Iqbal, Bob Byers, Gale Burstein, Thomas Peterman, Catherine Lindsey Satterwhite, Cornelis Rietmeijer, John Douglas, Sheana Bull, Doug Richardson, Mark Foster, Stuart Cooper, Julie Caine, Rebecca Rothbard, Terry Sapp-Jones, Lesley Brooks, Lydia O'Donnell, Alexi San Doval, Athi Myint-U, Richard Duran, Carl O'Donnell, Kevin Malotte, Shelley Vrungos, Nettie DeAugustine, Chris Kau, Inez Denson, Marina Ohlson Smorick, Ann Marie Bernhard, Jeffrey Klausner, Gregory Greenwood, Carolyn Hunt, Elizabeth Varela, Kevin Filocamo, David Bandy

Abstract

Background: Sexually 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 findings: In 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).

Conclusions: Showing 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).

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Trial Profile
Figure 1. Trial Profile
Figure 2. Laboratory-Confirmed Infection among Patients at…
Figure 2. Laboratory-Confirmed Infection among Patients at Sexually Transmitted Disease Clinics in Three U.S. Cities, December 2003 through August 2005, by Study Condition

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Source: PubMed

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