Background: Persons infected with gonorrhea (GC) and/or chlamydia (CT) are at high risk for reinfection. Infections may be asymptomatic, leading to continued transmission. Non-invasive tests allow easy re-testing. Well-planned, brief counseling interventions have been shown to have a positive behavioral impact in areas such as STD risk reduction and addictive behaviors. Monetary incentives have been shown to increase return for appointments. Methods: Participants (n=224) treated for GC and/or CT at one of two public STD clinics (Prince George’s County, MD or Los Angeles County, CA) were randomly assigned to one of three interventions designed to encourage return for re-testing in three months. These were 1) brief recommendation to return (n=76), 2) intervention 1 plus $20 incentive paid at return visit (n=72), or 3) intervention 1 plus motivational interview at time of first visit and phone reminder prior to the return date (n=76). The main outcome measure was client return for the scheduled 3-month appointment. Results: Return rates were 7%, 7%, and 24% respectively. After controlling for demographic variables and clinic site using multivariate logistic regression, the odds ratios for interventions 2 and 3, respectively, compared to intervention 1 were 1.1 (95% CI 0.3-4.2) and 6.1 (95% CI 2.5-15.0). Conclusions: Contrary to expectations, a monetary incentive did not increase the return rate compared to a brief recommendation. The intervention including a motivational interview and reminder did increase return rates. Further research on psychosocial determinants is needed to understand how this intervention had its effect.
Learning Objectives: At the conclusion of the session, participants will be able to 1) describe three different approaches to encouraging return for STD re-testing, and 2) identify the most effective method found in this study.
Keywords: STD Prevention, Health Behavior
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.