Program decreases recurrent STDs in teens

NEW YORK (Reuters Health) - Sexual Awareness for Everyone, or the SAFE, program has shown promise in curbing recurrent bouts of common sexually transmitted diseases among high-risk teenage girls, researchers report.

They found that a group of 14- to 18-year-old Mexican-American and African-American girls who participated in the SAFE program were less apt to engage in risky sexual behavior and had a statistically lower incidence of recurrent gonorrhea and Chlamydia infection in the first 6 months and over time, compared with teenage girls in a control group.

The SAFE program also curbed STD reinfection rates and risky sexual behavior among adult women ages 19 and older in the study.

"Although not specifically designed for teens, the SAFE intervention worked very well in this high-risk population," Dr. Andrea Ries Thurman from University of Texas Health Sciences Center San Antonio and colleagues report in the current issue of the medical journal Obstetrics and Gynecology.]

As part of the SAFE program, teen girls attended small-group meetings on STD prevention. Sessions included role-playing, interactive video, handouts, and group discussion to emphasize a number of preventive strategies such as periodic abstinence, mutual monogamy, correct and consistent use of condoms, the importance of taking prescribed STD medication as directed and avoiding sexual intercourse until finishing the medication, not douching, and seeing their doctor whenever they suspect an STD infection.

The overall goals of the SAFE program are to have participants recognize their risk for contracting STDs including HIV, the virus that causes AIDS, commit to changing their risky behavior and acquire the skills needed to be successful, Thurman's team explains.

The results showed that the cumulative reinfection rate (0-12 months) was roughly 24 percent among teens in the SAFE program compared with 40 percent among teens in the control group who received only 15 minutes of individual STD risk reduction counseling. None of the study teens became infected with HIV during the study.

The cumulative reinfection rate was 12 percent among women ages 19 or older in the SAFE program compared with 18 percent among their counterparts in the control group.

Teenagers as a group had higher rates of STD reinfection (33.1 percent) than adults (14.4 percent), the investigators found, "because the behavior that was most highly and consistently associated with recurrent infection in teens - unprotected sex with untreated partners - was not sufficiently modified by the SAFE intervention."

Thurman and colleagues conclude that STD prevention interventions for teenagers need to "emphasize skills to help teens ensure their partners are treated or to otherwise refuse intercourse."

SOURCE: Obstetrics and Gynecology, June 2008.