***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: Background : Sexually transmitted disease ( STD ) , including AIDS , disproportionately affects African-American and Hispanic women . Goal : To evaluate efficacy of st and ard and enhanced ( addition of optional support groups ) gender- and culture-specific , small-group behavioral interventions , compared to interactive STD counseling , in high risk minority women for two years . Methods : Women with a non-viral STD were treated and enrolled in a r and omized trial . Follow-up screens and interviews occurred at 6 months , 1 year , 18 months ( short interview , optional exam ) and 2 years . The primary outcome was subsequent infection with chlamydia and /or gonorrhea . Secondary outcomes included risky sexual behaviors . We employed logistic regression based on intention-to-treat . Results : Data from 775 women were included ; the retention rate was 91 % . Adjusted infection rates were higher in the controls in Year 1 ( 26.8 % ) , Year 2 ( 23.1 % ) , and cumulatively ( 39.8 % ) than in the enhanced ( 15.4 % , P = 0.004 ; 14.8 % , P < 0.03 ; 23.7 % , P < 0.001 , respectively ) and st and ard ( 15.7 % , P = 0.006 ; 14.7 % , P = 0.03 ; 26.2 % , P < 0.008 , respectively ) intervention arms at these time points . Enhanced-intervention women who opted to attend support groups ( attendees ) had the lowest adjusted infection rates in Year 1 ( 12.0 % ) and cumulatively ( 21.8 % ) . Intervention women in general , but particularly attendees , were significantly less likely than controls to have repeat infections . Multiple partners and unprotected sex with an untreated or incompletely treated partner helped explain group differences in infection . Conclusions : Risk-reduction interventions significantly decreased both single and multiple infective episodes with chlamydia and /or gonorrhea and risky sexual behaviors in the two-year study period . Support-group attendance appeared to contribute additional risk reduction in Year 1 OBJECTIVES We sought to assess the effectiveness of approaches targeting improved sexually transmitted infection ( STI ) sexual partner notification through patient referral . METHODS From January 2002 through December 2004 , 600 patients with Neisseria gonorrhoeae or Chlamydia trachomatis were recruited from STI clinics and r and omly assigned to either a st and ard-of-care group or a group that was counseled at the time of diagnosis and given additional follow-up contact . Participants completed an interview at baseline , 1 month , and 6 months and were checked at 6 months for gonorrhea or chlamydial infection via nucleic acid amplification testing of urine . RESULTS Program participants were more likely to report sexual partner notification at 1 month ( 86 % control , 92 % intervention ; adjusted odds ratio [ AOR ] = 1.8 ; 95 % confidence interval [ CI ] = 1.02 , 3.0 ) and were more likely to report no unprotected sexual intercourse at 6 months ( 38 % control , 48 % intervention ; AOR = 1.5 ; 95 % CI = 1.1 , 2.1 ) . Gonorrhea or chlamydial infection was detected in 6 % of intervention and 11 % of control participants at follow-up ( AOR = 2.2 ; 95 % CI = 1.1 , 4.1 ) , with greatest benefits seen among men ( for gender interaction , P = .03 ) . CONCLUSIONS This patient-based sexual partner notification program can help reduce risks for subsequent STIs among urban , minority patients presenting for care at STI clinics The objective of this study was to determine acceptability and feasibility of patient-based partner referral ( PBPR ) and patient-delivered partner medication ( PDPM ) among female sexually transmitted infection ( STI ) patients in a community-based STI screening study . Women were r and omized to STI screening at home or at a clinic . STI patients could choose between PBPR and PDPM . Six-week follow-up interviews , and in-depth interviews , were conducted . STI prevalence was high . Most of the 106 women with an STI chose PDPM , mainly because partners would not have time or would not want to attend a clinic , and to ensure that partners received treatment . Nearly all partners reportedly took medication ( 94 ; 89 % took it in front of the woman ) or went to a clinic for treatment ( 92 % ) . No adverse events were reported . Good communication emerged as the key to successful partner notification . In conclusion , PDPM could be used as a strategy to improve STI treatment coverage Background : Expedited partner therapy ( EPT ) has been shown to reduce the risk of persistent or recurrent gonorrhea and chlamydial infection in heterosexuals , and to increase the proportion of sex partners receiving treatment . The objective of this analysis was to evaluate the consistency of EPT 's effect across sociodemographic and behavioral subgroups . Methods : Subset analyses from a r and omized controlled trial compared EPT to st and ard partner referral ( SPR ) in sociodemographic and behaviorally defined subgroups . Outcomes included persistent or recurrent infection in study participants and participants ' report that their partners received treatment . Results : Reinfection risk was lower among EPT recipients than nonrecipients in 21 of 22 subgroups , with relative risks ( RRs ) varying from 0.4 to 0.94 . Compared to persons receiving SPR , persons receiving EPT were more likely to report that their partners were very likely to have been treated in 33 of 34 subgroups ( RRs range , 1.03 - 1.36 ) . Although EPT reduced the risk of persistent or recurrent infection somewhat more in men ( RR , 0.56 ; 95 % CI , 0.3 - 1.08 ) than in women ( RR , 0.81 ; 95 % CI , 0.61 - 1.07 ) and more in persons with gonorrhea ( RR , 0.32 ; 95 % CI , 0.13 - 0.78 ) than those with chlamydial infection ( RR , 0.82 ; 95 % CI , 0.63 - 1.07 ) , the RR of partners being treated associated with EPT was similar in men ( RR , 1.21 ; 95 % CI , 1.05 - 1.39 ) and women ( RR , 1.18 ; 95 % CI , 1.10 - 1.27 ) , and also in persons with gonorrhea ( RR , 1.33 ; 95 % CI , 0.80 - 2.23 ) and chlamydial infection ( RR , 1.33 ; 95 % CI , 1.07 - 1.66 ) . Conclusions : In this study , EPT is shown to be superior to SPR across a wide spectrum of sociodemographic and behaviorally defined subgroups Background Repeated infection with Chlamydia trachomatis increases the risk for serious sequelae : pelvic inflammatory disease , ectopic pregnancy , infertility , and chronic pelvic pain . A substantial proportion of women treated for C trachomatis infection are reinfected by an untreated male sex partner in the first several months after treatment . Effective strategies to ensure partner treatment are needed . Goal The goal of the study was to determine whether repeated infections with C trachomatis can be reduced by giving women doses of azithromycin to deliver to male sex partners . Study Design A multicenter r and omized controlled trial was conducted among 1787 women aged 14 to 34 years with uncomplicated C trachomatis genital infection diagnosed at family planning , adolescent , sexually transmitted disease , and primary care clinics or emergency or other hospital departments in five US cities . Women treated for infection were r and omized to one of two groups : patient-delivered partner treatment ( in which they were given a dose of azithromycin to deliver to each sex partner ) or self-referral ( in which they were asked to refer their sex partners for treatment ) . The main outcome measure was C trachomatis DNA detected by urine ligase chain reaction ( LCR ) or polymerase chain reaction ( PCR ) by 4 months after treatment . Results The characteristics of study participants enrolled in each arm were similar except for a small difference in the age distribution . Risk of reinfection was 20 % lower among women in the patient-delivered partner treatment arm ( 87/728 ; 12 % ) than among those in the self-referral arm ( 106/726 ; 15 % ) ; however , this difference was not statistically significant ( odds ratio , 0.80 ; 95 % confidence interval , 0.62–1.05;P = 0.102 ) . Women in the patient-delivered partner treatment arm reported high compliance with the intervention ( 82 % ) . Conclusion Patient-delivered partner treatment for prevention of repeated C trachomatis infection among women is comparable to self-referral and may be an appropriate option for some patients OBJECTIVES To determine the effectiveness of an intervention for  pharmacy workers  in improving their recognition and management of sexually transmitted disease ( STD ) syndromes . METHODS We r and omly selected 14 districts ( total population nearly 4 million ) from the 24 districts of low socioeconomic status in Lima , Peru . We r and omly assigned paired districts to receive training and support for management and prevention of STDs or a control intervention about management of diarrhoea . The STD intervention included interactive luncheon seminars on recognition and management of four STD syndromes ( urethral discharge , vaginal discharge , genital ulcers , and pelvic inflammatory disease ) and STD/HIV prevention counselling ; monthly pharmacy visits by " prevention salespersons " who distributed material s that included " STD/HIV prevention packets " containing information , condoms , and cards given to patients for referral of their sex partners ; and workshops for physicians on managing patients with STD syndromes referred from pharmacies . St and ardized simulated patients visited pharmacies in intervention and control districts at one , three , and six months after training to assess outcomes . FINDINGS St and ardized simulated patients reported significantly better recognition and management ( appropriate antimicrobial regimens provided for discharge syndromes and referral to specially trained physicians for genital ulcers or pelvic inflammatory disease ) by pharmacy workers of all four STD syndromes . They also reported significantly more frequent recommendations for use of condoms and treatment of partners at pharmacies in intervention districts than in control districts ( by " intention-to-train " analyses , P<0.05 for 47/48 primary outcome comparisons ) . CONCLUSION Training was feasible and effectively improved pharmacy workers '  practice BACKGROUND We sought to compare two methods of notifying sex partners of subjects infected with the human immunodeficiency virus ( HIV ) or persons who had shared needles with them ( needle-sharing partners )  : " patient referral , " in which the responsibility for notifying partners was left to the patient , and " provider referral , " in which providers attempted to notify partners . METHODS Names of sex partners and needle-sharing partners and information on how to locate them were obtained from consenting HIV-infected subjects identified in the HIV-testing programs at three public health departments in North Carolina . The subjects were r and omly assigned to a patient-referral group ( in which patients had the initial responsibility for notifying their partners ) or a provider-referral group ( in which the study counselor notified the partners ) . The success of attempts to notify partners was monitored by means of interviews with counselors conducted both in the field and at the health department . RESULTS Of 534 HIV-positive persons identified at the health departments , 247 ( 46 percent ) did not return for counseling after the test , 8 were counseled outside the study , and 117 ( 22 percent ) were ineligible . Of the 162 invited to participate , 88 ( 54 percent ) declined and 74 ( 46 percent ) agreed . The subjects were mostly male ( 69 percent ) , black ( 87 percent ) , homosexual or bisexual ( 76 percent of the men ) , and had a median age of 30 years . Thirty-nine were assigned to the provider-referral group and 35 to the patient-referral group . In the provider-referral group 78 of 157 partners ( 50 percent ) were successfully notified , whereas in the patient-referral group only 10 of 153 ( 7 percent ) were notified . Of the partners notified by the counselors , 94 percent were not aware that they had been exposed to HIV . Overall , 23 percent of the partners notified and tested were HIV-positive . CONCLUSIONS In this trial , leaving the notification of partners up to the subjects ( patient referral ) was quite ineffective , despite the North Carolina law requiring that partners be notified . Partner notification by public health counselors ( provider referral ) was significantly more effective . Although the effectiveness of notification procedures is constrained by the accuracy of the information provided by HIV-infected patients , counselors who notify the partners of an infected patient can refer them to educational , medical , and support services targeted to persons at high risk for HIV infection and may encourage the adoption of less risky behavior Background : Screening has been recommended to reduce the prevalence and morbidity associated with genital chlamydia infection in the United Kingdom . Methods : We describe the rationale and study design of the Chlamydia Screening Studies ( ClaSS ) , a collaborative project design ed to evaluate screening outside genitourinary medicine clinics . A non-selective , active screening approach in 16–39 year olds r and omly sample d from 27 general practice lists in the Bristol and Birmingham areas formed the 
    Output:
    
contract referral , 4 .
Where measured , there was no statistical evidence of differences in the incidence of adverse effects between PN strategies .
The evidence assessed in this review does not identify a single optimal strategy for PN for any particular STI .
When combining trials of STI causing urethritis or cervicitis , expedited partner therapy was more successful than simple patient referral for preventing re-infection of the index patient but was not superior to enhanced patient referral .
Expedited partner therapy interventions should include all components that were part of the trial intervention package .
There was insufficient evidence to determine the most effective components of an enhanced patient referral strategy .