Safe Sex Texts Do Not Cut Sexually Transmitted Disease Reinfection Rates


FRIDAY, Oct. 7, 2022 — Regular text messages targeting safer sex behaviors in young adults do not cut the incidence of chlamydia or gonorrhea at one year, according to a study published online Sept. 28 in The BMJ.

Caroline Free, from the London School of Hygiene and Tropical Medicine, and colleagues quantified the effects of a series of text messages (safetxt) delivered in the community on the incidence of chlamydia and gonorrhea reinfection at one year in people aged 16 to 24 years. The analysis included 4,675 young adults randomly assigned to either safetxt or control texts.

The researchers found that at one year, the cumulative incidence of chlamydia or gonorrhea reinfection was 22.2 percent in the safetxt arm versus 20.3 percent in the control arm (odds ratio, 1.13; 95 percent confidence interval, 0.98 to 1.31). The number needed to harm was 64. The groups were similar with respect to the risk for road traffic incidents and partner violence.

“Our text message intervention was grounded in psychological theory, incorporating the best evidence on health behavior change, but it did not have the effects we anticipated,” the authors write. “In light of our results, the WHO [World Health Organization] should revise its endorsement of digital behavior change communication for strengthening health systems, to specify which topics and content WHO endorses.”

Abstract/Full Text

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