Evaluation of a cognitive-behavioral, group, randomized controlled intervention trial to prevent sexually transmitted infections and unintended pregnancies in young women

Prev Med. 2005 Apr;40(4):420-31. doi: 10.1016/j.ypmed.2004.07.004.


Background: Few cognitive-behavioral interventions have focused on preventing sexually transmitted infections (STIs) and unintended pregnancies (UPs) in young, sexually active women in a single study. Military recruit training provides a well-defined, national, nonclinic sample in which to evaluate such an intervention.

Methods: All female Marine recruits (N=2,288) in training were approached. Of these, 2,157 (94.3%) voluntarily agreed and were randomly assigned, by platoons, to participate in cognitive-behavioral interventions to prevent STIs or UPs or to prevent physical training injuries and cancer. Participants completed self-administered questionnaires and were screened for pregnancy, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis at baseline and, on average, 1 and 14 months postintervention.

Results: A higher proportion of the control group had a postintervention STI or UP [odds ratio (OR)=1.41, 95% confidence interval (CI)=1.01-1.98]. Among participants who had no history of STIs or pregnancy, but who engaged in risky sexual behaviors just before recruit training, the control group was more likely to acquire a postintervention STI (OR=3.24, CI=1.74-6.03). Among participants who were not sexually experienced at baseline, the control group was more likely to have casual (OR=2.05, 95% CI=1.04-4.08) and multiple (OR=1.87, 95% CI=1.01-3.47) sexual partners postintervention.

Conclusions: This randomized controlled trial indicates that cognitive-behavioral interventions are effective for reducing behavioral risk and preventing STIs and UPs in young, sexually active women who are not seeking health care.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Condoms
  • Educational Status
  • Female
  • Health Behavior
  • Humans
  • Marital Status
  • Military Personnel
  • Pregnancy
  • Pregnancy, Unwanted
  • Program Evaluation / statistics & numerical data*
  • Risk Factors
  • Sex Education / methods*
  • Sex Education / standards
  • Sexual Behavior* / psychology
  • Sexual Partners
  • Sexually Transmitted Diseases / prevention & control*
  • Socioeconomic Factors