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Sexual Risk Reduction Interventions for Patients Attending Sexually Transmitted Disease Clinics in the United States: A Meta-Analytic Review, 1986 to Early 2009

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Sexually transmitted disease (STD) patients are more likely to experience a future STD including human immunodeficiency virus (HIV). The aim of this study was to examine the efficacy of behavioral interventions to reduce sexual risk behavior and incident STDs among patients attending STD clinics in the United States. A meta-analysis of 32 studies with 48 separate interventions targeting STD patients (N = 67,538) was conducted. Independent raters coded study, sample, and intervention characteristics. Effect sizes, using both fixed- and random-effects models, were calculated. Potential moderators of intervention efficacy were assessed. Relative to controls, intervention participants increased their condom use and had fewer incident STDs, including HIV, across assessment intervals (d +s ranging from 0.05 to 0.64). Several sample (e.g., age and ethnicity) and intervention features (e.g., targeting intervention to a specific group) moderated the efficacy of the intervention. Behavioral interventions targeted to STD clinic patients reduce sexual risk behavior and prevent HIV/STDs. Widespread use of behavioral interventions in STD clinics should be a public health priority.

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Notes

  1. Insufficient variability in type of control condition for most dependent variables meant that comparisons between active comparisons and assessment-only controls were not possible. Among the dependent variables with sufficient variability for type of control, no significant differences were found.

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Authors and Affiliations

  1. Center for Health and Behavior, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244-2340, USA

    Lori A. J. Scott-Sheldon Ph.D., Robyn L. Fielder MS & Michael P. Carey Ph.D.

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  1. Lori A. J. Scott-Sheldon Ph.D.
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  2. Robyn L. Fielder MS
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  3. Michael P. Carey Ph.D.
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Correspondence to Lori A. J. Scott-Sheldon Ph.D..

Additional information

References marked with an asterisk indicate studies included in the meta-analysis.

References marked with a dagger indicate supplemental manuscripts providing intervention details and additional measurement occasions for the 32 included studies.

This research was facilitated by National Institute of Health Grant R01-MH068171 to Michael P. Carey. We thank the study authors who provided additional intervention details or data for this study.

Electronic supplementary material

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Table A1

Linear regression analyses testing funnel plot asymmetry (DOC 53 kb)

Figure A1

Condom use at short-term assessment (k = 31) (DOC 49 kb)

Figure A2

Condom use at intermediate assessment (k = 26) (DOC 68 kb)

Figure A3

Condom use at long-term assessment (k = 13) (DOC 69 kb)

Figure A4

Number of partners at short-term assessment (k = 24) (DOC 69 kb)

Figure A5

Number of partners at intermediate assessment (k = 22) (DOC 69 kb)

Figure A6

Number of partners at long-term assessment (k = 11) (DOC 68 kb)

Figure A7

Incident STDs at short-term assessment (k = 8) (DOC 69 kb)

Figure A8

Incident STDs at intermediate assessment (k = 21) (DOC 69 kb)

Figure A9

Incident STDs at long-term assessment (k = 23) (DOC 69 kb)

Figure A10

HIV at long-term assessment (k = 5) (DOC 69 kb)

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Scott-Sheldon, L.A.J., Fielder, R.L. & Carey, M.P. Sexual Risk Reduction Interventions for Patients Attending Sexually Transmitted Disease Clinics in the United States: A Meta-Analytic Review, 1986 to Early 2009. ann. behav. med. 40, 191–204 (2010). https://doi.org/10.1007/s12160-010-9202-8

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