Evaluation of a community-based organization's intervention to reduce the incidence of sexually transmitted diseases: A randomized, controlled trial

Background: The study objectives were to determine whether a community-based organization's intensive counseling intervention would reduce sexually transmitted disease (STD) acquisition among high-risk STD clinic patients and to determine whether a low-cost trial could be conducted in a community-based setting with passive follow-up. Methods: Participants were randomly assigned to routine counseling or intensive counseling consisting of three I-hour sessions. We reviewed clinic records to determine I-year cumulative incidence of STD. Results: From September 1994 through December 1995, we enrolled 581 high-risk black men. Among the intervention group, 38% did not attend any intervention session; 38% attended all three. The 1-year cumulative incidence of STD did not differ significantly between the intervention (16%) and control groups (12%) (P = 0.20). Conclusion: Our results suggest that the intensive counseling did not reduce STD acquisition. We encountered problems in conducting this low-cost trial, making results difficult to interpret. Future trials should schedule follow-up STD assessments and will likely need more staff.