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Cited by 973HIV/AIDS Research and InterventionsAdolescent Sexual and Reproductive HealthHIV, Drug Use, Sexual Risk

Efficacy of Risk-Reduction Counseling to Prevent Human Immunodeficiency Virus and Sexually Transmitted Diseases: A Randomized Controlled Trial

Kamb, Mary L., Fishbein, Martin, Douglas, Jr, John M., Rhodes, Fen, Rogers, Judy, Bolan, Gail, Zenilman, Jonathan, Hoxworth, Tamara +8 more·1998·JAMA
DOI 10.1001/jama.280.13.1161
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Abstract

CONTEXT: The efficacy of counseling to prevent infection with the human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) has not been definitively shown. OBJECTIVE: To compare the effects of 2 interactive HIV/STD counseling interventions with didactic prevention messages typical of current practice. DESIGN: Multicenter randomized controlled trial (Project RESPECT), with participants assigned to 1 of 3 individual face-to-face interventions. SETTING: Five public STD clinics (Baltimore, Md; Denver, Colo; Long Beach, Calif; Newark, NJ; and San Francisco, Calif) between July 1993 and September 1996. PARTICIPANTS: A total of 5758 heterosexual, HIV-negative patients aged 14 years or older who came for STD examinations. INTERVENTIONS: Arm 1 received enhanced counseling, 4 interactive theory-based sessions. Arm 2 received brief counseling, 2 interactive risk-reduction sessions. Arms 3 and 4 each received 2 brief didactic messages typical of current care. Arms 1, 2, and 3 were actively followed up after enrollment with questionnaires at 3, 6, 9, and 12 months and STD tests at 6 and 12 months. An intent-to-treat analysis was used to compare interventions. MAIN OUTCOME MEASURES: Self-reported condom use and new diagnoses of STDs (gonorrhea, chlamydia, syphilis, HIV) defined by laboratory tests. RESULTS: At the 3- and 6-month follow-up visits, self-reported 100% condom use was higher (P<.05) in both the enhanced counseling and brief counseling arms compared with participants in the didactic messages arm. Through the 6-month interval, 30% fewer participants had new STDs in both the enhanced counseling (7.2%; P= .002) and brief counseling (7.3%; P= .005) arms compared with those in the didactic messages arm (10.4%). Through the 12-month study, 20% fewer participants in each counseling intervention had new STDs compared with those in the didactic messages arm (P = .008). Consistently at each of the 5 study sites, STD incidence was lower in the counseling intervention arms than in the didactic messages intervention arm. Reduction of STD was similar for men and women and greater for adolescents and persons with an STD diagnosed at enrollment. CONCLUSIONS: Short counseling interventions using personalized risk reduction plans can increase condom use and prevent new STDs. Effective counseling can be conducted even in busy public clinics.

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  • Project RESPECT demonstrated that client-centered STI and HIV prevention counseling was associated with lower acquisition of curable STIs, including trichomoniasis, chlamydia, gonorrhea, and syphilis.

    “Although one large study in STI clinics (Project RESPECT) demonstrated that this approach was associated with lower acquisition of curable STIs (e.g., trichomoniasis, chlamydia, gonorrhea, and syphilis) (5)”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [5]

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Authors
Kamb, M. L., Fishbein, M., Douglas, Jr., Rhodes, F., Rogers, J., Bolan, G., Zenilman, J., Hoxworth, T., Malotte, C. K., Iatesta, M., Kent, C., Lentz, A., Graziano, S., Byers, R. H., Peterman, T. A., & for the Project RESPECT Study Group
Affiliations
Centers for Disease Control and Prevention (US)
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
1998-10-07
Volume
280
Issue
13
Pages
1161
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.280.13.1161
OpenAlex
W2153335467
Cited by
973
References
22
Citations by year
2026: 5 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 14 · 2021: 11 · 2020: 11 · 2019: 17 · 2018: 21 · 2017: 18 · 2016: 32 · 2015: 26 · 2014: 57 · 2013: 35 · 2012: 49
FWCI
29.60
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
HIV prevention, sexually transmitted infections, risk reduction counseling, condom use, STD incidence, gonorrhea, chlamydia, syphilis, HIV, STD clinics, adolescents, HIV-negative patients, sexual behavior change
MeSH terms
Adolescent, Adult, Community Health Services, Counseling, Female, Humans, Male, Risk Factors, Sexually Transmitted Diseases, United States, HIV Infections

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