Dyadic Intervention for Sexually Transmitted Infection Prevention in Urban Adolescents and Young Adults (The SEXPERIENCE Study): Protocol for a Randomized Controlled Trial (Preprint)

Abstract

Adolescents and young adults (AYA) less than 25 years of age have the highest rates of sexually transmitted infections (STI) in the United States. Current STI prevention strategies for AYA rely primarily on individual approaches, leaving sexual partners with significant unmet sexual and reproductive healthcare and health education needs. Dyadic interventions may hold promise for harnessing the power of communal coping within relationship dynamics to enhance sexual decision-making, communication, and behavior changes that reduce the future risk of STIs.

This paper describes the protocol and research methods of a dyad-based behavioral intervention that augments individual evidence-based interventions with joint health education counseling for heterosexual AYA dyads within a primary care setting. The trial aims to improve partner communication and collaborative sexual decision making, and to promote the adoption of sexual behaviors such as consistent condom use. The primary objective of this study is to assess the feasibility, acceptability and effectiveness of a dyadic intervention targeted at preventing STIs in heterosexual couples in an urban setting.

One hundred AYA (50 dyads) aged 16-25 years, engaged in heterosexual intercourse, who reside in the city, and are willing to recruit their main sexual partner for the study will be recruited and randomized into two groups; an intervention arm and a control arm. Participants will be recruited from an AYA Medicine Clinic and using social media (Facebook and Instagram). The index participant and partner will complete a single individual session separately (Sister to Sister / Focus on the Future) with a gender-matched health educator. Dyads will then be randomized to receive an additional joint debriefing session together to discuss relationship dynamics, condom negotiation etc. Participants will separately complete a telephone interview 6 weeks post intervention to determine the feasibility, acceptability and impact of the intervention on mutual sexual negotiation, consistency of condom use, communal coping skills, etc.

So far, 44 (25%) of 173 eligible participants have been enrolled and randomized. Participants are mostly females (90.9%), with at least a high school diploma (87%), and 9.0 average lifetime sexual partners. Acceptability is high, with 97.5% of participants expressing satisfaction with their study experience. 100% of dyads recruited were still together at 6-week follow-up.

Findings from this study will add to the current literature on the approaches to STI prevention and its success will inform its application in risk reduction counselling for youth who are most at risk.

Clinical Trials.gov identifier (NCT number): NCT03275168