Related Experiment Videos
Randomized controlled trials of individual-level, population-level, and multilevel interventions for preventing
Lisa E Manhart1, King K Holmes
1Departments of Medicine and Epidemiology and Center for AIDS and STD, University of Washington, Seattle, WA 98104, USA.
Background:
Previous reviews of interventions to prevent sexually transmitted infections (STIs) focused mostly on human immunodeficiency virus (HIV) infection. We reviewed trials of interventions to prevent sexual transmission of any STI, employing a multilevel perspective.
Methods:
We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and recent unpublished presentations through 2003, to identify randomized controlled trials of preventive STI interventions having systematic, objective measurement of STI outcomes. We classified trials according to intervention target and level of randomization (individual, group, or community); impact target (acquisition, transmission, or complications of STI); and primary intervention modality.
Results:
Of 83 trials identified, 41 met inclusion criteria, including trials of 28 individual-level, 9 group-level, and 4 community-level interventions. Among individual- and group-level interventions, 32 targeted acquisition, 4 targeted transmission, and 1 targeted complications of STI. The 4 intervention modalities most often used included behavior change (12 studies), vaccination (7 studies), use of topical microbicides (10 studies), and prophylactic, curative, or suppressive therapy (10 studies). Community-level interventions had multiple impact targets, and 2 interventions used multiple modalities. Only 1 intervention showed efficacy against sexual transmission of HIV, but 22 (53.7%) showed effectiveness against other STIs.
Conclusion:
Although many interventions have been found to be effective against STIs, few have been replicated, widely implemented, or carefully evaluated for effectiveness in other settings.
Related Concept Videos
Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Amebiasis
Sexually Transmitted Infections
Retrovirus Life Cycles
Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
Randomized Experiments
Simple randomization
Simple...