Background:
Early screening and treatment of CT and NGC infections in young women is critical to reduce the risk of PID. Few interventions designed to promote STI screening in response to high-risk sexual behavior among young women have been evaluated.


Objective:
Using a randomized controlled trial design, the efficacy of a client-centered intervention that used motivational counseling to promote STI screening in response to seven high-risk target behaviors was evaluated.

Method:
376 sexually active minority women aged 16 to 23 years were recruited from an urban reproductive health clinic, May 2002 to February 2003. Participants were randomized to two groups: intervention plus standard-care, and standard-care alone. Standard-care included risk-reduction counseling. The intervention group received two 50-minute counseling sessions conducted by a health counselor two weeks apart plus a 6-month booster session. Scheduled assessments to evaluate sexual and contraceptive behaviors were conducted at baseline, 6-months and 12-months. Outcome measures included: at least 1 STI visit in response to target behaviors (primary) and number of CT/NGC episodes (secondary) over the three study periods: baseline to 6-months, 6- to 12-months, and baseline to 12-months.

Result:
168 subjects made at least 1 STI visit during the study period. The distribution of at least 1 STI visit did not differ between groups for the three study periods (p=0.3, 0.5, 0.34). Longitudinal analyses (generalized estimating equation modeling) revealed that group was not associated with at least 1 STI visit overtime. Also, for each of the three study periods, there were no significant differences between groups for number of CT/NGC episodes (p=0.4, 0.9 and 0.7).

Conclusion:
The intervention did not promote increased STI screening behavior relative to standard care in young women already seeking clinic services

Implications:
Further research is needed on the efficacy of behavioral interventions for young women not already seeking services.