To evaluate counseling efficacy among high-risk groups, the researchers conducted a subset analysis of data collected from July 1993 through September 1996 during a randomized, controlled trial (Project RESPECT). The 4,328 participants from five public STD clinics in the United States were assigned to enhanced counseling, brief counseling, or educational messages. The researchers compared STD outcomes for those assigned to either type of counseling with STD outcomes for those assigned to educational messages for nine subgroups: sex, age, city, education, prior HIV test, STD at enrollment, race/ethnicity, injection drug use, and exchanging sex for money/drugs.

After 12 months, all subgroups assigned to counseling — whether brief or enhanced — had fewer STDs than those who received educational messages. The incidence of STDs was similar for most subgroups assigned to enhanced or brief counseling. All subgroups experienced an appreciable number of STDs prevented per 100 persons counseled — particularly adolescents (9.4 per 100) and subjects with STD at enrollment (8.4 per 100).

HIV/STD counseling, whether brief or enhanced, resulted in fewer STDs for all subgroups of clinic clients — including high-risk groups like adolescents and persons with STDs at enrollment — than did educational messages, the authors concluded.