Petersen Ruth, Albright Jennifer, Garrett Joanne M, Curtis Kathryn M
Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
Perspect Sex Reprod Health. 2007 Mar;39(1):21-8. doi: 10.1363/3902107.
Given levels of unintended pregnancy and STDs, an effective counseling intervention is needed to improve women's consistent use of effective prevention methods.
A sample of 764 women aged 16-44 who were at risk of unintended pregnancy were enrolled in a randomized controlled trial in North Carolina in 2003-2004. Intervention participants received pregnancy and STD prevention counseling, adapted from motivational interviewing, both at enrollment and two months later; controls received only a session of general health counseling. Levels of contraceptive use (categorized as high, low or none on the basis of the effectiveness of the method and the consistency of use) and barriers to use were measured at two, eight and 12 months; chi-square tests were used to compare selected outcomes between the groups. Rates of unintended pregnancy and chlamydia infection were assessed over the study period.
At baseline, 59% of all participants reported a high level of contraceptive use, 19% a low level and 22% nonuse. At two months, the proportions of intervention and control participants who had improved their level of use or maintained a high level (72% and 66%, respectively) were significantly larger than the proportions who had reported a high level of use at baseline (59% and 58%, respectively). No significant differences were found between the groups at 12 months, or between baseline and 12 months for either group. During the study, 10-11% of intervention and control participants became pregnant, 1-2% received a chlamydia diagnosis and 7-9% had another STD diagnosed.
Repeated counseling sessions may be needed to improve contraceptive decision-making and to reduce the risk of unintended pregnancy and STDs.
鉴于意外怀孕和性传播疾病的发生率，需要一种有效的咨询干预措施来提高女性对有效预防方法的持续使用。
2003年至2004年，在北卡罗来纳州对764名年龄在16 - 44岁、有意外怀孕风险的女性进行了一项随机对照试验。干预组参与者在入组时和两个月后接受了根据动机性访谈改编的怀孕和性传播疾病预防咨询；对照组仅接受了一次一般健康咨询。在两个月、八个月和十二个月时测量避孕措施的使用水平（根据方法的有效性和使用的一致性分为高、低或无）以及使用障碍；使用卡方检验比较两组之间的选定结果。在研究期间评估意外怀孕和衣原体感染的发生率。
在基线时，所有参与者中有59%报告避孕措施使用水平高，19%使用水平低，22%未使用。在两个月时，干预组和对照组中使用水平提高或保持高水平的参与者比例（分别为72%和66%）显著高于基线时报告使用水平高的比例（分别为59%和58%）。在十二个月时两组之间未发现显著差异，任何一组在基线和十二个月之间也未发现显著差异。在研究期间，干预组和对照组中有10 - 11%的参与者怀孕，1 - 2%被诊断为衣原体感染，7 - 9%被诊断患有其他性传播疾病。
可能需要多次咨询会议来改善避孕决策，并降低意外怀孕和性传播疾病的风险。
