1 Department of Family Medicine, University of Michigan , Ann Arbor, Michigan.
2 Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, Rhode Island.
J Womens Health (Larchmt). 2018 Jan;27(1):83-92. doi: 10.1089/jwh.2017.6408. Epub 2017 Oct 5.
Sexually transmitted infections (STIs) are an increasingly critical and costly health problem for American childbearing women. Pregnant women who misuse substances are more likely to engage in risky sexual behavior that leads to STIs. Substance use and risky sex during pregnancy are both associated with numerous negative consequences for the woman and the developing fetus.
A two-group, randomized controlled trial.
Recruitment of 50 pregnant women (30% Latina; 24.4 years old [SD = 5.31]) with an average of 13 weeks gestation (SD = 4.5 weeks) was conducted at a prenatal clinic in a large inner-city hospital. Recruitment took place between 2015 and 2016, and data analysis took place in 2016.
A computer-delivered, single-session brief motivational intervention plus booster session addressing both substance use and STI risk.
To assess participants' perceptions of the intervention and to examine the preliminary efficacy in reduction of substance use and risky sex at 4-month follow-up assessment.
There were consistently very high ratings of acceptability of the intervention, ranging between 6.3 and 6.8 on a 1-7 scale. At the 4-month follow-up, participants in the intervention arm reported a significantly larger reduction (54%) in any marijuana or alcohol use compared with participants in the control group (16%) (p = 0.015) based on two-group clustered logistic regression using a generalized estimating equations approach. There was a higher reduction in condomless vaginal sex at follow-up in the health checkup for expectant moms (HCEM) arm than control (27% vs. 5%), although this was not significant (p = 0.127).
The results of this pilot study are encouraging with respect to the acceptability and preliminary efficacy of an intervention in reducing alcohol/marijuana use and condomless sex during pregnancy, supporting the next step of testing the intervention in a larger sample.
性传播感染（STIs）是美国生育期妇女日益严重且代价高昂的健康问题。滥用药物的孕妇更有可能进行危险的性行为，从而导致 STIs。怀孕期间的药物使用和危险性行为都与女性和发育中的胎儿的许多负面后果有关。
一项两组成组、随机对照试验。
在一家大型市内医院的产前诊所招募了 50 名孕妇（30%拉丁裔；24.4 岁 [SD=5.31]），平均妊娠 13 周（SD=4.5 周）。招募工作于 2015 年至 2016 年进行，数据分析于 2016 年进行。
一种计算机提供的、单次简短动机干预加助推器会议，针对药物使用和 STI 风险。
评估参与者对干预措施的看法，并检验在 4 个月随访评估中减少药物使用和危险性行为的初步效果。
参与者对干预措施的接受度始终非常高，在 1-7 的评分中，评分范围在 6.3 到 6.8 之间。在 4 个月的随访中，与对照组（16%）相比，干预组（54%）的任何大麻或酒精使用量明显减少（p=0.015），这是基于使用广义估计方程方法的两组成组聚类逻辑回归。在 HCEM 组中，与对照组（27%对 5%）相比，随访时无保护的阴道性交减少率更高，但这并不显著（p=0.127）。
这项初步研究的结果令人鼓舞，因为该干预措施在减少怀孕期间的酒精/大麻使用和无保护性行为方面具有可接受性和初步疗效，支持在更大样本中测试该干预措施的下一步。
