Women seen by their doctor and diagnosed with a sexually transmitted infection (STI) are significantly more likely, compared to women seen for a non-STI diagnosis, to visit their doctor again within 18 months for STIs and STI-related conditions, according to a recent study in the Department of Health Services Research.

Women with an STI diagnosis had a significantly greater likelihood of subsequent visits for STIs, pelvic inflammatory disease, candidiasis (yeast infection), trichomoniasis (vaginitis), cervical dysplasia, abnormal bleeding, high-risk pregnancy and mental health problems.

"The association between an STI diagnosis and relatively high rates of resource utilization provides additional justification, should any be needed, for aggressive efforts to target such women with effective prevention programs, both to improve individual and public health and to reduce health care costs," Department Chair and Principal Investigator Sandra Wilson, Ph.D., said.

"However, at present, intervention to prevent future infection typically is not undertaken in a systematic manner upon diagnosis of an STI. Such interventions involve some cost - and their effectiveness in preventing further STIs remains to be adequately demonstrated," she added. Such is the goal of a randomized control trial of a specific educational intervention, Practicing Safer Sex Today (Psst!), which involves adult women who have been diagnosed with an STI.

The Psst! intervention aims to help participants acquire information about STIs and HIV, identify personal risk, become motivated to protect their reproductive health, identify and overcome barriers to implementing new behavior, and implement and maintain safer sex behaviors.

Researchers will determine whether there are significant differences between the group that received the intervention and the group that received standard care. "If successful, this intervention can easily be replicated at clinics and hospitals within routine health-education class offerings," Dr. Wilson said.

In a separate study, researchers are evaluating an HIV prevention intervention for injection-drug-using women. The workshop-format intervention provides information about safer sex and injection practices, free testing for STIs and HIV, and resources and referrals to local services.

Researchers have found that a statistically significant number of women have chosen to be tested for HIV after completing the intervention and also are more likely to carry condoms and exchange needles. "In general, the feedback suggests that this type of intervention is very important for these women, who report frequently feeling ostracized by public health agencies because of their drug use," Principal Investigator Nancy Brown, Ph.D., said.


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