Comprehensive Health Centre/Epidemiology Research and Training Unit, Jamaica Ministry of Health, Kingston, Jamaica.
Sex Transm Dis. 2013 Feb;40(2):105-10. doi: 10.1097/OLQ.0b013e31827938a1.
The effectiveness of counseling messages to avoid unprotected sex during short-term treatment for curable sexually transmitted infections is unknown.
We randomized 300 female STI clinic patients 18 years or older with cervicitis and/or vaginal discharge in Kingston, Jamaica, in 2010 to 2011, to 1 of 2 counseling messages for their course of syndromic treatment: abstinence only or abstinence backed up by condom use. At a follow-up visit 6 days afterward, we collected vaginal swabs to test for prostate-specific antigen (PSA), a biological marker of recent semen exposure, and administered a questionnaire assessing sexual behavior.
No differences were found in the proportions of women testing positive for PSA at follow-up in the abstinence-plus-condom group (11.9%) and abstinence-only group (8.4%) (risk difference, 3.5; 95% confidence interval, -3.5 to 10.5). There also was no significant difference in reporting of unprotected sex between groups. Reporting a history of condom use before enrollment significantly modified the effect of counseling arm on PSA positivity (P = 0.03). Among those reporting recent condom use, 10.3% in the abstinence-only arm and 4.8% in the abstinence-plus-condom arm tested positive for PSA. Conversely, among those not reporting recent condom use, 6.5% in the abstinence-only arm and 17.3% in the abstinence-plus-condom arm had PSA detected.
We found no evidence to support the superiority of either counseling message. Post hoc analyses suggest that women with recent condom experience may benefit significantly more from abstinence-plus-condom messages, whereas women without such experience may benefit significantly more from abstinence-only messages. Providers should weigh individual condom use history when determining the most appropriate counseling message.
在治疗可治愈性传播感染的短期治疗期间，避免无保护性行为的咨询信息的有效性尚不清楚。
我们在 2010 年至 2011 年期间，在牙买加金斯敦将 300 名年龄在 18 岁及以上的患有宫颈炎和/或阴道分泌物的性传播感染诊所女性患者随机分为 2 组，每组接受 1 种咨询信息：仅禁欲或禁欲并辅以使用避孕套。在 6 天后的随访中，我们采集阴道拭子检测前列腺特异性抗原（PSA），PSA 是最近精液暴露的生物标志物，并进行了一项评估性行为的问卷。
在随访时，在禁欲加避孕套组（11.9％）和禁欲组（8.4％）中，检测出 PSA 阳性的女性比例没有差异（风险差异，3.5；95％置信区间，-3.5 至 10.5）。两组之间在报告无保护性行为方面也没有显着差异。在登记前报告有使用避孕套的历史显着改变了咨询臂对 PSA 阳性的影响（P = 0.03）。在报告最近使用避孕套的人中，禁欲组中有 10.3％，而禁欲加避孕套组中有 4.8％的 PSA 检测呈阳性。相反，在未报告最近使用避孕套的人中，禁欲组中有 6.5％，而禁欲加避孕套组中有 17.3％的 PSA 检测呈阳性。
我们没有发现任何证据支持任何一种咨询信息的优越性。事后分析表明，有近期避孕套使用经验的女性可能会从禁欲加避孕套信息中受益匪浅，而没有这种经验的女性可能会从禁欲信息中受益匪浅。提供者在确定最合适的咨询信息时，应权衡个人避孕套使用史。
