Study explores effects

WASHINGTON (AP) —Training in safe sex practices can significantly reduce the spread of AIDS and other diseases, according to the largest study ever among men and women most susceptible to the infections.
A study involving about 3,700 men and women recruited at inner-city clinics in five states showed special safe sex training courses can increase by up to 50 percent the number of people who avoid unprotected sex.
The study, supported by an agency of the National Institutes of Health, appears Friday in the journal Science.
Experts said the seven safe sex training sessions used in the study cost about $278 per trainee but could save thousands of health care dollars by limiting the spread of HIV, the virus that causes AIDS. Treating an HIV patient with anti-viral drugs now costs about $12,000 a year, researchers say.
The new research is the largest controlled study in the United States designed to measure the effectiveness of modifying sexual behavior among men and women who attend public health care clinics.
Ann O’Leary, a Rutgers University psychologist and one of the study’s seven primary authors, said the research demonstrates convincingly that education and training in small groups can have a major impact on sexual behavior and on the spread of sexually transmitted disease, including AIDS.
“Behavior science and prevention are becoming increasingly respected and employed in medicine,” O’Leary said. “With HIV, it is all we have in terms of prevention. It’s clear we will not have a vaccine for years.”
Dr. Steven E. Hyman, director of the National Institute of Mental Health, the sponsoring NIH agency, said changing the risk behavior of people “is still the best way to prevent new HIV infections.
“If these behavioral changes were maintained for even one year, there would be a profound, cost-effective, public health impact in the communities that adopted this program,” he said in a statement.
In the study, men and women were recruited from 37 inner-city clinics in five metropolitan areas. Eligibility requirements included having engaged in unprotected sex during the previous 90 days, plus one of the following: sex with multiple and new partners, infection with a sexually transmitted disease, sex with a partner known to have multiple partners, sex with an injection drug user or sex with an HIV patient.
O’Leary said people meeting these characteristics are among the most likely to contract HIV or other sexually transmitted diseases.
People in the control group attended a safe sex video presentation that included a question and answer session.
In the study group, the men and women were broken into small groups with an instructor who talked about and guided group discussion of safe sex measures during seven sessions of one to two hours. Instructions included the proper use of condoms and such matters as self-control, partner selection and the effect of alcohol and other substances on sexual behavior.
People in the control group received food, gifts and $10 to $15 per session, said O’Leary.
Afterward, members of both groups were interviewed every three months for a year, and records were kept of their reported use of condoms or incidences of unprotected sex. They also were monitored for symptoms of chlamydia and gonorrhea, two sexually-transmitted diseases that increase the risk of contracting HIV.
O’Leary said that condom use increased from zero to 27 percent for the control group, and from zero to 42 percent in the study group. At some clinics, half of the study group members reported consistent use of condoms, she said.