Repeat Sexually Transmitted Infection (STI) Patients: Tailored Socio-Contextual Intervention to Reduce HIV Risk

"1. Develop strengths based case management intervention using input from interviews with repeat STI patients, consultants, \& piloting.~2. Recruit/enroll in the intervention 500 subjects (50% women; African American focus).~3. After subjects receive STI diagnosis, treatment,\& partner notification services, randomly assign subjects to:~ A. The STI strengths-based prevention case management, or B. Standard care.~4. Assess participants' risk behavior, determinants of behavior \& quality of life. Investigators will assess the incidence of new STI \& test the efficacy of the intervention relative to control.~5. Conduct a qualitative evaluation. Investigators will sample repeaters and non-repeaters from the experimental group.~6. Conduct cost effectiveness analyses of intervention compared to the standard."

Currently, the total time spent in an STI exam w/men is 30 minutes \& 60 w/women. More time is devoted to patients with sexual assault hx. Reason for the visit, symptoms, STI hx, contraception, condom use, number/gender of partners \& number/type of sexual activities are assessed. The nurse takes a health hx and asks about typical HIV risks behavior. Due to time the risk assessment is 5 minutes. A risk reduction kit including condoms is issued. Information includes symptoms/treatment of STI, location of sexual health clinics, location of free condoms \& testing/treatment resources. Referral information is provided when needed \& more involved w/sexual assault survivors. Partner notification is conducted w/syphilis and HIV. This didactic process follows the medical model.