Background:
The evaluation visit may be the only opportunity STD clinic staff has to promote risk reduction behavior among patients.

Objective:
Using a randomized clinical trial (RCT), the goal of the study was to evaluate the efficacy of a one-time, 15-minute intervention designed to increase consistent condom use and decrease the rates of STDs among patients. The interactive intervention was delivered via an audio, multimedia, computer-based system which delivered individualized messages to patients based on their readiness to change their condom use behavior with their main partners.

Method:
Participants were recruited from the waiting area of an urban STD clinic. Participants were randomly assigned by gender, stratified by stage of change, via the computer to the intervention group or to a multiple health risk assessment comparison group. After the completion of the 15-minute computer experience, urine specimens for Neisseria gonorrhoeae and Chlamydia trachomatis were obtained. Using an intention-to-treat protocol, consistent condom use and STD rates were assessed at the 6-month follow-up.

Result:
Of the 630 patients approached, 593 (94%) agreed to participate and 430 had complete data. The majority was African American (88%); 54.5% female; mean age was 24.5 yrs. (SE ± .23). At the 6-month assessment the results indicated a 6.6% increase in consistent condom use in the treatment group compared to a 5.5% decline in the comparison condition (p=.03.). STD rates in the intervention group decreased from baseline by l4.6% in the intervention group vs. 9.4% in the control group (p=.04).


Conclusion:
The findings suggest that an interactive, individualized intervention delivered at the evaluation visit has the potential to increase condom use and reduce STDs.

Implications:
This low cost computerized intervention could be intergrated into the routine evaluation visit within STD clinics.