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

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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, Malotte, C. Kevin, Iatesta, Michael, Kent, Charlotte, Lentz, Andrew, Graziano, Sandra, Byers, Robert H., Peterman, Thomas A., for the Project RESPECT Study Group·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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Latkin, C. A., Donnell, D. J., Metzger, D. S., Sherman, S. G., Aramrattna, A., Davis-Vogel, A., Quan, V. M., Gandham, S., Vongchak, T., Perdue, T., et al. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.11.019 · Cited by 163
Using Intervention Theory to Model Factors Influencing Behavior Change
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“In each case, data were collected following standardized procedures outlined in a common protocol (Kamb et al., 1996, 1998).”
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Self-Reported Hepatitis C Virus Antibody Status and Risk Behavior in Young Injectors
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A Pooled Analysis of the Effect of Condoms in Preventing HSV-2 Acquisition
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“…used to analyze data from HIV prevention trials as a means of assessing change over time with extremely skewed sexual behavior data (e.g., Kamb et al., 1998; National Institute of Mental Health [NIMH] Multisite HIV Prevention Trial Group, 1998;Otto-Salaj et al., 2001;Voluntary HIV-1…”
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Is Lack of Sexual Assertiveness among Adolescent and Young Adult Women a Cause for Concern?
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“Evidence from intervention that delivered behavioural counselling showed reduction in re-infection and new incidence of STI , thus this can reduce transmission of infection to the newborn, as well as improve the health of the woman during pregnancy and in the first year after birth [173-175].”
Sexually acquired syphilis
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Condom Use Errors and Problems Among College Men
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Effect of Risk-Reduction Counseling With Rapid HIV Testing on Risk of Acquiring Sexually Transmitted Infections: The AWARE Randomized Clinical Trial
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Barriers and Facilitators to Adolescent HIV Testing
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Prevention for Substance-Using HIV-Positive Young People
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Condom-use errors and problems
Crosby, R. A., Sanders, S. A., Yarber, W. L., & Graham, C. A. (2003) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(03)00015-1 · Cited by 127
Vulnerability of women in southern Africa to infection with HIV: biological determinants and priority health sector interventions
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Motivational Intervention to Reduce Rapid Subsequent Births to Adolescent Mothers: A Community-Based Randomized Trial
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HIV Prevention in Clinical Care Settings
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The Efficacy of Behavioral Interventions in Reducing HIV Risk Sex Behaviors and Incident Sexually Transmitted Disease in Black and Hispanic Sexually Transmitted Disease Clinic Patients in the United States: A Meta-Analytic Review
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“Of 15 published studies we identified with follow-up assessment periods of approximately 1 year or more, 9 demonstrated maintenance of behavior change (Ehrhardt et al., 1992; El-Bassel and Schilling, 1992; Voluntary HIV-1 Counseling and Testing Efficacy Study Group, 2000; Kamb et al., 1998; Landis et al., 1992; McCusk…”
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Comparing the Cost-Effectiveness of HIV Prevention Interventions
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HIV prevalence, previous HIV testing, and condom use with clients and regular partners among Senegalese commercial sex workers
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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: Kamb, Mary L.
Bolan, Gail
Hoxworth, Tamara
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 › Medicine › Public Health, Environmental and Occupational Health › 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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Efficacy of Risk-Reduction Counseling to Prevent Human Immunodeficiency Virus and Sexually Transmitted Diseases: A Randomized Controlled Trial

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