From the Departments of Epidemiology.
Social, Behavioral, and Population Sciences, Tulane University, School of Public Health & Tropical Medicine, New Orleans, LA.
Sex Transm Dis. 2023 Jun 1;50(6):329-335. doi: 10.1097/OLQ.0000000000001784. Epub 2023 Feb 20.
Black older-teenaged women have disproportionately high rates of sexually transmitted infections (STI) and unintended pregnancy (UTP). Internet-based interventions can be delivered to large groups of people in a relatively inexpensive manner. In this randomized trial, we examine the efficacy of an evidence-based STI/UTP prevention intervention adapted for older teens and for Internet delivery.
Black women aged 18-19 years who were not pregnant/seeking to become pregnant were enrolled (n = 637) and randomized to an 8-session intervention or attention control and were followed up at 6/12 months postintervention. The primary outcome was defined as uptake of reliable contraceptives. Other secondary outcomes were examined, including intention to use condoms, intention to use reliable contraception, and STI or pregnancy rates.
Overall, at baseline, reliable contraception was 54.8% and dual protection was 29.4%, and the prevalence of STI was 11.1%. Participants were similar by arm for most factors considered. Participation and follow-up rates were excellent (60.9% and 80.3%). There was no statistically significant difference in uptake of reliable contraception for intervention versus controls at 6 months (1.45 [0.99-2.12]) or 12 months (1.33 [0.92-1.91]). At 6 months, several secondary outcomes were improved/trended toward improvement in intervention compared with control, but this effect waned by 12 months, except for intention to use condoms which remained improved.
The intervention was efficacious for increasing some self-reported UTP and STI prevention behaviors, which waned over time, and the intervention had minimal impact on STI or pregnancy rates suggesting that this type of online intervention may need additional components.
黑人青少年晚期女性的性传播感染（STI）和意外怀孕（UTP）率不成比例地高。基于互联网的干预措施可以以相对较低的成本提供给大量人群。在这项随机试验中，我们研究了为年龄较大的青少年和互联网提供服务而改编的基于证据的 STI/UTP 预防干预措施的效果。
招募了年龄在 18-19 岁、未怀孕/寻求怀孕的黑人女性（n=637），并将其随机分为 8 节干预组或对照组，并在干预后 6/12 个月进行随访。主要结果定义为可靠避孕方法的使用率。还检查了其他次要结果，包括使用避孕套的意愿、使用可靠避孕方法的意愿以及 STI 或怀孕率。
总体而言，在基线时，可靠避孕的比例为 54.8%，双重保护的比例为 29.4%，STI 的患病率为 11.1%。大多数考虑因素中，两组参与者的情况相似。参与率和随访率都很高（分别为 60.9%和 80.3%）。在 6 个月（1.45 [0.99-2.12]）或 12 个月（1.33 [0.92-1.91]）时，干预组与对照组在可靠避孕方法的使用率上没有统计学上的显著差异。在 6 个月时，与对照组相比，干预组的一些次要结果得到改善/呈改善趋势，但到 12 个月时，这种效果减弱，除了使用避孕套的意愿仍有所改善。
该干预措施对于增加某些自我报告的 UTP 和 STI 预防行为有效，但随着时间的推移，效果减弱，该干预措施对 STI 或怀孕率的影响很小，这表明这种类型的在线干预可能需要额外的内容。
