A video-based waiting room intervention, Safe in the City, lowers STD incidence among STD clinic patients, new CDC data find. In a controlled trial, the Safe in the City research group found that patients who were exposed to a 23-minute HIV/STD prevention video had nearly a 10% reduction in new infections compared with those who were not exposed to the video.
The research study to evaluate the Safe in the City intervention was conducted among patients attending STD clinics in three US cities. All patients attending those clinics during a two year period were included in the study, in which the intervention condition (i.e., the Safe in the City video and movie-style posters) and the control condition (i.e., standard waiting room experience) were systematically administered in alternating 4-week blocks of time. Clinical medical record data and external county STI surveillance registries were reviewed to identify and compare incident infections between the two study groups. Of 38,635 patients included, the incident STI rate was lower in the intervention condition (4.9%) than the control condition (5.7%). Strong intervention effects were observed among male patients (13% reduction in STIs) and those who were diagnosed with an infection at the beginning of the study (14% reduction).
Video interventions in clinic settings offer a practical mechanism for delivering HIV/STD prevention messages because of their relative low cost and ease of implementation, likely acceptability, and high likelihood of being adopted and sustained over time. In previous studies of STD clinic patients, brief video-based interventions, typically combined with individual or small-group counseling, have been associated with reductions in risky sexual behavior and new infections. However, the staffing and space required to administer counseling present barriers to adoption. In this study, simply attending the clinic during times that the video was showing, without any separate counseling, was associated with nearly a 10% reduction in STIs. While the results of this study demonstrate a relatively modest reduction in STIs compared to more intensive risk reduction programs, the simplicity and practicality of showing a video on waiting room televisions could prove to have significant public health benefits if adopted by STD clinics nationally.
Citation: Warner L, Klausner JD, Rietmeijer CA, Malotte CK, O'Donnell L, et al. (2008) Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics. PLoS Med 5(6): e135.