***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The purpose of this study was to document the effectiveness of small group condom motivation education in reducing new and reinfection rates of sexually transmitted diseases ( STD ) among female teenagers . Two hundred and five ( 205 ) female adolescents ( age 13 - 20 ) with a current STD were studied at two sites of a Teen Health Clinic . There were 86 teens in the Study Group and 119 in the Comparison Group . Patients were sample d from December 1992 to July 1993 . The patients in the Study Group received a condom motivation class given by the clinic STD educator in small groups of four or more adolescents . The Comparison Group , comparable in age and ethnicity , received treatment for their STD but did not participate in condom motivation classes . All teens were given treatment and condoms . The sample was followed for 6 months . The total number of patients returning with new infections was 21 ( 14.7 % ) . The total number of patients with reinfections was 14 ( 9.8 % ) . There were no significant differences between the Study and Comparison Group on return rates , new and reinfection rates or on any socio-demographic variables . The comparison of these groups suggests that a specific condom motivation class has minimal effectiveness in urban teens . However , almost 70 % of the teens returned to the clinic for their scheduled visits . It is suggested that adolescent clinics which combine family planning and STD treatment services maintain high client enrollment and therefore may be ideal locations to initiate new and continuous interventions for condom use especially for high risk teens Objective : To test the efficacy of brief , safer-sex counseling by medical providers of HIV-positive patients during medical visits . Setting : Six HIV clinics in California . Design : Clinics were r and omized to intervention arms evaluated with cohorts of r and omly selected patients measured before and after the intervention . Participants : Five-hundred and eighty-five HIV-positive persons , sexually active prior to enrollment . Interventions : Prevention counseling from medical providers supplemented with written information . Two clinics used a gain-framed approach ( positive consequences of safer-sex ) , two used a loss-frame approach ( negative consequences of unsafe sex ) , and two were attention-control clinics ( medication adherence ) . Interventions were given to all patients who attended the clinics . Outcome measure : Self-reported unprotected anal or vaginal intercourse ( UAV ) . Results : Among participants who had two or more sex partners at baseline , UAV was reduced 38 % ( P < 0.001 ) among those who received the loss-frame intervention . UAV at follow-up was significantly lower in the loss-frame arm [ odds ratio ( OR ) , 0.42 ; 95 % confidence interval ( CI ) , 0.19–0.91 ; P = 0.03 ] compared with the control arm . Using generalized estimating equations ( GEE ) to adjust for clustering did not change the conclusions ( OR , 0.34 ; 95 % CI , 0.24–0.49 ; P = 0.0001 ) . Similar results were obtained in participants with casual partners at baseline . No effects were seen in participants with only one partner or only a main partner at baseline . No significant changes were seen in the gain-frame arm . Conclusions : Brief provider counseling emphasizing the negative consequences of unsafe sex can reduce HIV transmission behaviors in HIV-positive patients presenting with risky behavioral profiles Objective : To evaluate the effectiveness of a clinician-delivered intervention , implemented during routine clinical care , in reducing unprotected sexual behavior  of HIV-infected patients . Design : A prospect i ve clinical trial comparing the impact of a clinician-delivered intervention arm vs. a st and ard-of-care control arm on unprotected sexual behavior  of HIV-infected patients . Setting : The 2 largest HIV clinics in Connecticut . Participants : A total of 497 HIV-infected patients , aged ≥18 years , receiving HIV clinical care . Intervention : HIV clinical care providers conducted brief client-centered interventions at each clinical encounter that were design ed to help HIV-infected patients reduce unprotected sexual behavior . Main Outcome Measures : Unprotected insertive and receptive vaginal and anal intercourse and unprotected insertive oral sex ; unprotected insertive and receptive vaginal and anal intercourse only . Results : HIV-infected patients who received the clinician-delivered intervention showed significantly reduced unprotected insertive and receptive vaginal and anal intercourse and insertive oral sex over a follow-up interval of 18 months ( P < 0.05 ) . These behaviors increased across the study interval for patients in the st and ard-of-care control arm ( P < 0.01 ) . For the measure of unprotected insertive and receptive vaginal and anal sex only , there was a trend toward a reduction in unprotected sex among intervention arm participants over time ( P < 0.09 ) , and a significant increase in unprotected sex in the st and ard-of-care control arm ( P < 0.01 ) . Conclusions : A clinician-delivered HIV prevention intervention targeting HIV-infected patients result ed in reductions in unprotected sex . Interventions of this kind should be integrated into routine HIV clinical care OBJECTIVE To determine whether condom use among high-risk female adolescents could be increased by a behavioral intervention , with the use of infection with Chlamydia trachomatis as a biomarker of condom practice s. DESIGN Prospect i ve , r and omized , controlled intervention . SETTING Urban family planning and sexually transmitted disease clinics . PARTICIPANTS Two hundred nine female adolescents , aged 15 through 19 years , who were treated for C. trachomatis genitourinary infection , were r and omly assigned to st and ard ( control ) or experimental ( behavioral intervention ) groups . One hundred twelve subjects returned for follow-up 5 to 7 months after enrollment and comprise the study subjects . MEASUREMENTS Subjects completed a multiinstrument question naire measuring sexual behavior , condom practice s , attitudes and beliefs , cognitive complexity , sociodemographics , and motivation at enrollment and follow-up . Endourethral and endocervical sites were sample d for C. trachomatis . RESULTS Among the 112 subjects who returned for repeated examination , those who had received the experimental intervention reported increased use of condoms by their sexual partners for protection against sexually transmitted diseases ( odds ratio = 2.4 ; p = 0.02 ) and for vaginal intercourse ( odds ratio = 3.1 ; p = 0.005 ) at the 6-month follow-up . Multivariable logistic regression analysis controlling for condom use at enrollment demonstrated that the experimental intervention ( odds ratio = 2.8 ; p = 0.03 ) and the higher cognitive complexity ( odds ratio = 4.6 ; p = 0.02 ) independently contributed to greater condom use at follow-up . Despite greater use of condoms among the group who had received the intervention , use remained inconsistent and rates of reinfection with C. trachomatis were not significantly different ( 26 % vs 17 % ; p = 0.3 ) . CONCLUSION Although a brief behavioral intervention among high-risk female adolescents can increase condom use by their sexual partners , incident infection does not appear to be reduced , because condom use remained inconsistent Background Sexually transmitted disease ( STD ) prevention remains a public health priority . Simple , practical interventions to reduce STD incidence that can be easily and inexpensively administered in high-volume clinical setting s are needed . We evaluated whether a brief video , which contained STD prevention messages targeted to all patients in the waiting room , reduced acquisition of new infections after that clinic visit . Methods and Findings In a controlled trial among patients attending three publicly funded STD clinics ( one in each of three US cities ) from December 2003 to August 2005 , all patients ( n = 38,635 ) were systematic ally assigned to either a theory-based 23-min video depicting couples overcoming barriers to safer sexual behaviors , or the st and ard waiting room environment . Condition assignment alternated every 4 wk and was determined by which condition ( intervention or control ) was in place in the clinic waiting room during the patient 's first visit within the study period . An intent-to-treat analysis was used to compare STD incidence between intervention and control patients . The primary endpoint was time to diagnosis of incident laboratory-confirmed infections ( gonorrhea , chlamydia , trichomoniasis , syphilis , and HIV ) , as identified through review of medical records and county STD surveillance registries . During 14.8 mo ( average ) of follow-up , 2,042 patients ( 5.3 % ) were diagnosed with incident STD ( 4.9 % , intervention condition ; 5.7 % , control condition ) . In survival analysis , patients assigned to the intervention condition had significantly fewer STDs compared with the control condition ( hazard ratio [ HR ] , 0.91 ; 95 % confidence interval [ CI ] , 0.84 to 0.99 ) . Conclusions Showing a brief video in STD clinic waiting rooms reduced new infections nearly 10 % overall in three clinics . This simple , low-intensity intervention may be appropriate for adoption by clinics that serve similar patient population s. Trial registration : http://www . Clinical Trials.gov ( # NCT00137670 ) OBJECTIVE To evaluate the addition of structured contraceptive counseling to usual care on choice , initiation , and continuation of very effective contraception after uterine aspiration . METHODS We conducted a RCT of a version of the WHO Decision-Making Tool for Family Planning Clients and Providers with women having a procedure for a spontaneous or induced abortion . Our intervention provided structured , st and ardized counseling . We r and omized women to usual care or usual care with structured counseling . Our outcomes included choosing a very effective contraceptive method and 3 months continuation . RESULTS Fifty-four percent of all participants chose a very effective method . Women in the intervention group were no more likely to choose a very effective method ( OR 0.74 , 95 % CI 0.44 , 1.26 ) or to initiate their method compared to the usual care group ( OR 0.65 , 95 % CI 0.31 , 1.34 ) . In multivariate models , structured counseling was not associated with using a very effective method at 3 months ( AOR 1.06 , 95 % CI 0.53 , 2.14 ) . CONCLUSION In this setting , structured counseling had little impact on contraceptive method choice , initiation , or continuation . PRACTICE IMPLICATION S Adding structured counseling did not increase the proportion choosing or initiating very effective contraception in a practice setting where physicians already provide individualized counseling The purpose of this study was to evaluate the separate and combined effectiveness of brief and intensive interventions for sexual risk reduction among patients at a sexually transmitted disease ( STD ) clinic . Patients ( N = 1483 ; 54 % men ; 64 % African-American ; M = 29.2 years old ) were recruited from a publicly funded , walk-in STD clinic . Patients completed a baseline assessment , and then were r and omized to one of six intervention arms ; each arm combined a brief intervention with an intensive intervention . The interventions provided different levels of information , motivational counseling , and behavioral skills training , guided by theory , formative research , and empiric precedent . Follow-up assessment s , including STD screening , occurred at 3 , 6 , and 12 months post-intervention . The results showed that infection rates declined from 18.1 % at baseline to 4.5 % at 12 months . At a 3-month follow-up , patients reported fewer sexual partners , fewer episodes of unprotected sex , and a lower percentage of unprotected sexual events ; they strengthened sexual health knowledge , safer sex attitudes and intentions , and self-efficacy beliefs . No consistent pattern of differential risk reduction was observed among the six intervention conditions , nor was any evidence of decay from 3 to 12-month follow-ups obtained . We conclude that implementing behavioral interventions in a STD clinic was associated with significant reduction of sexual risk behavior and risk antecedents Few behavioral interventions have been conducted to reduce high-risk sexual behavior among HIV-positive Men who have Sex with Men ( HIV+ MSM ) . Hence , we lack well-proven interventions for this population . Positive Connections is a r and omized controlled trial ( n = 675 HIV+ MSM ) comparing the effects of two sexual health seminars — for HIV+ MSM and all MSM — with a contrast prevention video arm . Baseline , 6- , 12- and 18-month follow-up surveys assessed psychosexual variables and frequency of serodiscordant unprotected anal intercourse ( SDUAI ) . At post-test , intentions to avoid transmission were significantly higher in the sexual health arms . However , SDUAI frequency decreased equally across arms . HIV+ MSM engaging in SDUAI at baseline were more likely to leave the study . Tailoring interventions to HIV+ MSM did not increase their effectiveness in this study . A sexual health approach appeared as effective as an untailored video-based HIV prevention intervention in reducing SDUAI among HIV+ MSM Objectives Bacterial vaginosis ( BV ) is common in lesbians , and treatment fails in up to 28 % . Risks include sexual behaviours that transmit vaginal fluid . The authors measured efficacy of a behavioural intervention to reduce sexual transfer of vaginal fluid between female sex partners in reducing BV persistence . Methods Women aged 16–35 years with BV who reported sex with women ( prior year ) were eligible . Participants were r and omised to intervention ( motivational interviewing design ed to reduce sharing of vaginal fluid on h and s or sex toys post-treatment , by provision of condoms , glo 
    Output:
    
Sexually transmitted infections (STIs)/HIV were less often reported in the intervention group compared with the control group .
Condom use was higher in most studies in the intervention group .
Numbers of sexual partners and unprotected sexual intercourse were lower in the intervention groups .
There is evidence that brief counselling interventions have some effect in the reduction and prevention of STIs/HIV .