Alcohol-exposed pregnancy (AEP) is a significant public health problem in the United States. Sexually transmitted disease (STD) clinics serve female clients with a high prevalence of heavy alcohol consumption coupled with ineffective contraceptive use. Project CHOICES (Changing High-Risk AlcOhol Use and Increasing Contraception Effectiveness) is an evidence-based, brief intervention to lower risk of AEP by targeting alcohol and contraceptive behaviors through motivational interviewing and individualized feedback. We describe our experience integrating and implementing CHOICES in STD clinics. This endeavor aligns with CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's program collaboration and service integration strategic priority to strengthen collaborative work across disease areas and integrate services provided by related programs at the client level.
References
1.
Centers for Disease Control and Prevention (US). Program collaboration and service integration: Enhancing the prevention and control of HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis in the United States. Atlanta: Department of Health and Human Services (US), CDC; 2009. Also available from: URL: http://www.cdc.gov/nchhstp/programintegration/docs/207181-C_NCHHSTP_PCSI%20WhitePaper-508c.pdf [cited 2012 May 31].
IngersollKFloydLSobellM; The Project CHOICES Intervention Research Group. Reducing the risk of alcohol-exposed pregnancies: A study of a motivational intervention in community settings. Pediatrics2003;111(5 Pt 2):1131–5.
5.
IngersollKSCeperichSDNettlemanMDKarandaKBrocksenSJohnsonBA. Reducing alcohol-exposed pregnancy risk in college women: Initial outcomes of a clinical trial of a motivational intervention. J Subst Abuse Treat2005;29:173–80.
6.
TsaiJFloydRLGreenPPBoyleCA. Patterns and average volume of alcohol use among women of childbearing age. Matern Child Health J2007;11:437–45.
HuttonHEMcCaulMESantoraPBErbeldingEJ. The relationship between recent alcohol use and sexual behaviors: Gender differences among sexually transmitted disease clinic patients. Alcohol Clin Exp Res2008;32:2008–15.
9.
JohnsonHLErbeldingEJZenilmanJMGhanemKG. Sexually transmitted diseases and risk behaviors among pregnant women attending inner city public sexually transmitted diseases clinics in Baltimore, MD, 1996–2002. Sex Transm Dis2007;34:991–4.
10.
GodfreyEMWheatSGCyrierRWongWTrussellJSchwarzEB. Contraceptive needs of women seeking care from a publicly funded sexually transmitted infection clinic. Contraception2010;82:543–8.
11.
ShlayJCZolotLBellDMaraviMEUrbinaC. Association between provision of initial family planning services and unintended pregnancy among women attending an STD clinic. J Womens Health (Larchmt)2009;18:1693–9.
12.
ThomasAGBrodineSKShafferRShaferMABoyerCBPutnamS. Chlamydial infection and unplanned pregnancy in women with ready access to health care. Obstet Gynecol2001;98:1117–23.
13.
Department of Health and Human Services (US), Substance Abuse and Mental Health Services Administration. Results from the 2010 National Survey on Drug Use and Health: Summary of national findings. NSDUH Series H-41. Rockville (MD): SAMHSA; 2011. Also available from: URL: http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.htm#3.1.3 [cited 2012 May 15].
14.
Centers for Disease Control and Prevention (US). 2010 sexually transmitted diseases surveillance [cited 2012 May 16]. Available from: URL: http://www.cdc.gov/std/stats10/toc.htm
15.
CookRLComerDMWiesenfeldHCChangCHTarterRLaveJR. Alcohol and drug use and related disorders: An underrecognized health issue among adolescents and young adults attending sexually transmitted disease clinics. Sex Transm Dis2006;33:565–70.
16.
SethPSalesJMDiClementeRJWingoodGMRoseEPatelSN. Longitudinal examination of alcohol use: A predictor of risky sexual behavior and Trichomonas vaginalis among African-American female adolescents. Sex Transm Dis2011;38:96–101.
17.
StarasSAToblerALMaldonado-MolinaMMCookRL. Riskier sexual partners contribute to the increased rate of sexually transmitted diseases among youth with substance use disorders. Sex Transm Dis2011;38:413–8.
18.
SussALHomelPHammerschlagMBrombergK. Risk factors for pelvic inflammatory disease in inner-city adolescents. Sex Transm Dis2000;27:289–91.
19.
DiClementeRJWingoodGMSioneanCCrosbyRHarringtonKDaviesS. Association of adolescents' history of sexually transmitted disease (STD) and their current high-risk behavior and STD status: A case for intensifying clinic-based prevention efforts. Sex Transm Dis2002;29:503–9.
20.
FloydRLWeberMKDennyCO'ConnorMJ. Prevention of fetal alcohol spectrum disorders. Dev Disabil Res Rev2009;15:193–9.
21.
FloydRLSobellMVelasquezMMIngersollKNettlemanMSobellL; Project CHOICES Efficacy Study Group. Preventing alcohol-exposed pregnancies: A randomized controlled trial. Am J Prev Med2007;32:1–10.
22.
FloydRLEbrahimSTsaiJO'ConnorMSokolR. Strategies to reduce alcohol-exposed pregnancies. Matern Child Health J2006;10(5 Suppl):S149–51.
23.
ManwellLBFlemingMFMundtMPStauffacherEABarryKL. Treatment of problem alcohol use in women of childbearing age: Results of a brief intervention trial. Alcohol Clin Exp Res2000;24:1517–24.
Department of Health and Human Services (US), Substance Abuse and Mental Health Services Administration. Screening, brief intervention and referral to treatment (SBIRT) in behavioral healthcare. Rockville (MD): SAMHSA; 2011. Also available from: URL: http://www.samhsa.gov/prevention/SBIRT/SBIRTwhitepaper.pdf [cited 2012 May 22].
26.
KambMLFishbeinMDouglasJMJrRhodesFBolanGZenilmanJ. Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: A randomized controlled trial. Project RESPECT Study Group. JAMA1998;280:1161–7.
27.
JemmottLSJemmottJBIIIO'LearyA. Effects on sexual risk behavior and STD rate of brief HIV/STD prevention interventions for African American women in primary settings. Am J Public Health2007;97:1034–40.
28.
VelasquezMMIngersollKSSobellMBFloydRLSobellLCvon SternbergK. A dual-focus motivational intervention to reduce the risk of alcohol-exposed pregnancy. Cogn Behav Pract2010;17:203–12.
29.
Centers for Disease Control and Prevention (US). National Center on Birth Defects and Developmental Disabilities [cited 2013 Feb 5]. Available from: URL: http://www.cdc.gov/ncbddd/index.html
