Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 39, Number 1, March 2007

Pregnancy and STD Prevention Counseling Using an Adaptation of Motivational Interviewing: A Randomized Controlled Trial

By Ruth Petersen, Jennifer Albright, Joanne M. Garrett and Kathryn M. Curtis

CONTEXT: Given levels of unintended pregnancy and STDs, an effective counseling intervention is needed to improve women’s consistent use of effective prevention methods.

METHODS: A sample of 764 women aged 16–44 who were at risk of unintended pregnancy were enrolled in a randomized controlled trial in North Carolina in 2003–2004. Intervention participants received pregnancy and STD prevention counseling, adapted from motivational interviewing, both at enrollment and two months later; controls received only a session of general health counseling. Levels of contraceptive use (categorized as high, low or none on the basis of the effectiveness of the method and the consistency of use) and barriers to use were measured at two, eight and 12 months; chi-square tests were used to compare selected outcomes between the groups. Rates of unintended pregnancy and chlamydia infection were assessed over the study period.

RESULTS: At baseline, 59% of all participants reported a high level of contraceptive use, 19% a low level and 22% nonuse. At two months, the proportions of intervention and control participants who had improved their level of use or maintained a high level (72% and 66%, respectively) were significantly larger than the proportions who had reported a high level of use at baseline (59% and 58%, respectively). No significant differences were found between the groups at 12 months, or between baseline and 12 months for either group. During the study, 10–11% of intervention and control participants became pregnant, 1–2% received a chlamydia diagnosis and 7–9% had another STD diagnosed.

CONCLUSIONS: Repeated counseling sessions may be needed to improve contraceptive decision-making and to reduce the risk of unintended pregnancy and STDs.

Perspectives on Sexual and Reproductive Health, 2007, 39(1):21–28







 

Ruth Petersen is associate professor, Department of Maternal and Child Health, School of Public Health; Jennifer Albright is project manager, Center for Women’s Health Research; and Joanne M. Garrett is professor, Department of Obstetrics and Gynecology, School of Medicine—all at University of North Carolina, Chapel Hill. Kathryn M. Curtis is epidemiologist, Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta.