Orr D P, Langefeld C D, Katz B P, Caine V A
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA.
J Pediatr. 1996 Feb;128(2):288-95. doi: 10.1016/s0022-3476(96)70413-4.
To determine whether condom use among high-risk female adolescents could be increased by a behavioral intervention, with the use of infection with Chlamydia trachomatis as a biomarker of condom practices.
Prospective, randomized, controlled intervention.
Urban family planning and sexually transmitted disease clinics.
Two hundred nine female adolescents, aged 15 through 19 years, who were treated for C. trachomatis genitourinary infection, were randomly assigned to standard (control) or experimental (behavioral intervention) groups. One hundred twelve subjects returned for follow-up 5 to 7 months after enrollment and comprise the study subjects.
Subjects completed a multiinstrument questionnaire measuring sexual behavior, condom practices, attitudes and beliefs, cognitive complexity, sociodemographics, and motivation at enrollment and follow-up. Endourethral and endocervical sites were sampled for C. trachomatis.
Among the 112 subjects who returned for repeated examination, those who had received the experimental intervention reported increased use of condoms by their sexual partners for protection against sexually transmitted diseases (odds ratio = 2.4; p = 0.02) and for vaginal intercourse (odds ratio = 3.1; p = 0.005) at the 6-month follow-up. Multivariable logistic regression analysis controlling for condom use at enrollment demonstrated that the experimental intervention (odds ratio = 2.8; p = 0.03) and the higher cognitive complexity (odds ratio = 4.6; p = 0.02) independently contributed to greater condom use at follow-up. Despite greater use of condoms among the group who had received the intervention, use remained inconsistent and rates of reinfection with C. trachomatis were not significantly different (26% vs 17%; p = 0.3).
Although a brief behavioral intervention among high-risk female adolescents can increase condom use by their sexual partners, incident infection does not appear to be reduced, because condom use remained inconsistent.
以沙眼衣原体感染作为避孕套使用情况的生物标志物，确定行为干预能否增加高危女性青少年的避孕套使用。
前瞻性、随机、对照干预研究。
城市计划生育和性传播疾病诊所。
209名年龄在15至19岁之间、因沙眼衣原体泌尿生殖系统感染接受治疗的女性青少年，被随机分配到标准（对照）组或实验（行为干预）组。112名受试者在入组后5至7个月返回进行随访，构成研究对象。
受试者在入组和随访时完成一份多工具问卷，测量性行为、避孕套使用情况、态度和信念、认知复杂性、社会人口统计学和动机。采集尿道内和宫颈部位样本检测沙眼衣原体。
在112名返回接受复查的受试者中，接受实验干预的受试者报告称，在6个月随访时，其性伴侣为预防性传播疾病（优势比=2.4；P=0.02）和阴道性交（优势比=3.1；P=0.005）而使用避孕套的情况有所增加。对入组时的避孕套使用情况进行控制的多变量逻辑回归分析表明，实验干预（优势比=2.8；P=0.03）和较高的认知复杂性（优势比=4.6；P=0.02）独立促成了随访时更多的避孕套使用。尽管接受干预的组中避孕套使用有所增加，但使用情况仍然不稳定，沙眼衣原体再次感染率没有显著差异（26%对17%；P=0.3）。
尽管对高危女性青少年进行简短的行为干预可增加其性伴侣的避孕套使用，但由于避孕套使用仍然不稳定，新发感染似乎并未减少。
