Stone, Nicole, Graham, Cynthia, Bedford, Rowena D., Towler, Lauren, Jackson, Louise, Bremner, Stephen, Mcgrath, Nuala, Brown, Katherine, Newby, Kate, Clarke, Amanda, Morrison, Leanne, Nadarzynski, Tom, To, Ye, Perry, Nicky and Bayley, Jake (2025) Home-based intervention strategy to reduce new chlamydia infection among young men: the HIS-UK RCT. Public Health Research, 13 (8). (doi:10.3310/GJNS1528).
Abstract
Background: sexually transmitted infections pose a significant public health challenge in the United Kingdom, prompting the Department of Health and Social Care to prioritise sexually transmitted infection rate reduction as a means of addressing sexual health inequalities. Correct and consistent condom use is the most effective method of reducing sexually transmitted infection transmission.
Methods: a randomised controlled trial with three arms (two intervention arms and one control arm) was conducted to evaluate the effectiveness and cost-effectiveness of the home-based intervention strategy United Kingdom intervention in reducing chlamydia test positivity among 16- to 25-year-old men, and individuals with a penis, at risk of sexually transmitted infections. The home-based intervention strategy United Kingdom intervention, delivered either face to face by health promotion professionals or digitally through an interactive website, aimed to enhance condom use experiences and improve correct and consistent condom use. The control group received usual condom distribution care. Chlamydia screening was conducted at baseline and 6 months post randomisation, with follow-up through online questionnaires.
Of the 2387 individuals assessed for eligibility, 1233 were eligible, and 725 participants completed all baseline assessments and were randomised (health promotion professionals: 241, interactive website: 243, control: 241). Five hundred and eighty men received the intervention arm as randomised (health promotion professionals: 51.9%, interactive website: 93.8%, control: 94.2%); 51.7% of participants engaged during follow-up, with 21.4% providing baseline and follow-up chlamydia screening results.
Results: findings showed the home-based intervention strategy United Kingdom to be well received, with participants valuing the condom kit and materials promoting pleasurable condom use. At the primary end point, home-based intervention strategy United Kingdom participants showed a 4.9 percentage point reduction in chlamydia test positivity compared to the control (7.9% vs. 12.8%). The odds of a positive test were 55% lower for home-based intervention strategy United Kingdom participants compared to the control. However, this reduction was not statistically significant due to the lower-than-planned participant recruitment (a consequence of COVID-19) affecting the trial’s power. Home-based intervention strategy United Kingdom positively impacted recent condom use along with significant reductions in condom use errors and problems compared to the control. While no marked effect on consistent condom use emerged, attitudinal shifts were highly significant, with sustained positive condom attitudes, reduced perceived barriers and increased confidence in condom use among home-based intervention strategy United Kingdom participants.
Conclusion: the home-based intervention strategy United Kingdom education and training programme, in conjunction with the provision of a broad selection of products, demonstrated a positive impact on attitudes towards condoms and lubricants, increased confidence in correct condom use and reduced errors and problems. Recent condom and lubricant use increased, but consistent condom usage showed no significant improvement. The odds of a positive chlamydia test were lower for home-based intervention strategy United Kingdom participants, though not statistically significant. This study provides valuable insights into the potential of home-based intervention strategy United Kingdom to enhance sexual health practices among at-risk populations. While it is recognised that home-based intervention strategy United Kingdom is more costly than usual condom distribution care, incorporating key elements of the intervention and messaging into existing practice could offer benefits without making implementation unfeasible.
Funding: this synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number 17/54/06.
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