***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 
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    Input: We report results from a r and omized controlled trial design ed to evaluate the efficacy of a video-based sexual risk reduction intervention and to measure assessment reactivity .  Patients ( N = 1010 ; 56 % male ; 69 % African American ) receiving care at a sexually transmitted infection ( STI ) clinic were assigned to one of four conditions formed by crossing assessment condition ( i.e. , sexual health vs. general health ) with intervention condition ( i.e. , sexual risk reduction intervention vs. general health promotion ) . After completing their assigned baseline assessment , participants received their assigned intervention , and subsequently returned for follow-up assessment s at 3 , 6 , 9 , and 12 months . Participants in all conditions reduced their self-reported sexual risk behavior , and the incidence of new STIs declined from baseline through the follow-ups ; however , there was no effect of intervention or assessment condition . We conclude that further risk reduction will require more intensive interventions , especially in STI clinics that already provide excellent clinical care . ResumenPresentamos los result ados de un estudio experimental aleatorizado con grupo de control diseñado para evaluar la eficacia de una intervención basada en un video para reducir el comportamiento sexual de riesgo y para medir reactividad . Se crearon cuatro condiciones experimentales al cruzar las condiciones de evaluación ( es decir , salud sexual versus salud general ) con las de intervención ( es decir , reducción de comportamiento sexual de riesgo versus promoción de la salud general ) . Los pacientes , ( N = 1010 ; 56 % hombres ; 69 % afroamericanos ) que recibían atención en una clínica de infecciones de transmisión sexual ( ITS ) , fueron asignados a unas de las cuatro condiciones experimentales . Después de completar la evaluación inicial a la que fueron asignados , los participantes recibieron la intervención correspondiente y posteriormente regresaron para el seguimiento a los 3 , 6 , 9 y 12 meses . Los participantes en todas las condiciones redujeron su comportamiento de riesgo sexual , medido mediante un cuestionario que completaron ellos mismos , y la incidencia de nuevas infecciones de transmisión sexual se redujo compar and o cada seguimiento con la línea base . Sin embargo , no se observó efecto de la intervención o condición de comparación . Llegamos a la conclusión de que para reducir en mayor medida el comportamiento de riesgo sexual se requieren intervenciones más intensivas , sobre todo en las clínicas de ITS en las que ya se proporciona una excelente atención clínica OBJECTIVES We tested the efficacy of a brief intervention to promote correct and consistent use of condoms among Black male youths attending sexually transmitted infection ( STI ) clinics in 3 southern US cities . METHODS In 2010 to 2012 , we screened ( n = 1102 ) and enrolled ( n = 702 ) youths aged 15 to 23 years who identified as Black and reported recent ( past 2 months ) sexual activity and r and omized them to a private , brief , interactive intervention ( n = 349 ) or an attention-equivalent control condition ( n = 353 ) . Assessment s occurred at baseline and 2 and 6 months after the intervention . RESULTS At 6 months , with adjustment for age and pretest nonequivalence of the outcome variable , an estimated odds ratio ( EOR ) of 1.63 ( 95 % confidence interval [ CI ] = 1.07 , 2.49 ; P = .02 ) indicated efficacy for correct condom use . An adjusted generalized estimating equations model with both 2- and 6-month condom use variables produced an EOR of 1.49 ( 95 % CI = 1.06 , 2.08 ; P = .02 ) . We did not observe significant effects on chlamydia and gonorrhea incidence . CONCLUSIONS This brief intervention , delivered as part of STI clinical care , could help alleviate the disproportionate STI-HIV burden among young Black men Background We evaluated brief combination interventions to simultaneously reduce sexual and injection risks among female sex workers who inject drugs ( FSW-IDUs ) in Tijuana and Ciudad Juarez , Mexico during 2008–2010 , when harm reduction coverage was exp and ing rapidly in Tijuana , but less so in Juarez . Methods FSW-IDUs ≥18 years reporting sharing injection equipment and unprotected sex with clients within the last month participated in a r and omized factorial trial comparing four brief , single-session conditions combining either an interactive or didactic version of a sexual risk intervention to promote safer sex in the context of drug use , and an injection risk intervention to reduce sharing of needles/injection paraphernalia . Women underwent quarterly interviews and testing for HIV , syphilis , gonorrhea , Chlamydia and Trichomonas , blinding interviewers and assessors to assignment . Poisson regression with robust variance estimation and repeated measures ordinal logistic regression examined effects on combined HIV/STI incidence and receptive needle sharing frequency . Findings Of 584 initially HIV-negative FSW-IDUs , retention was ≥90 % . After 12 months , HIV/STI incidence decreased > 50 % in the interactive vs. didactic sex intervention ( Tijuana : AdjRR:0.38,95 % CI:0.16–0.89 ; Juarez : AdjRR:0.44,95 % CI:0.19–0.99 ) . In Juarez , women receiving interactive vs. didactic injection risk interventions decreased receptive needle-sharing by 85 % vs. 71 % , respectively ( p = 0.04 ) ; in Tijuana , receptive needle sharing declined by 95 % , but was similar in active versus didactic groups . Tijuana women reported significant increases in access to syringes and condoms , but Juarez women did not . Interpretation After 12 months in both cities , the interactive sexual risk intervention significantly reduced HIV/STI incidence . Exp and ing free access to sterile syringes coupled with brief , didactic education on safer injection was necessary and sufficient for achieving robust , sustained injection risk reductions in Tijuana . In the absence of exp and ing syringe access in Juarez , the injection risk intervention achieved significant , albeit more modest reductions , suggesting that community-level interventions incorporating harm reduction are more powerful than individual-level interventions . Trial Registration clinical trials.gov 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 0.9 
    Output:
    
Conclusions The technical content of brief behaviour interventions was identified in a reliable and st and ardized way providing preliminary indications on potentially effective techniques to achieve behaviour change