Motivational brief intervention for the prevention of sexually transmitted infections in travelers: a randomized controlled trial.

BACKGROUND: Sexually transmitted infections (STIs) are among the frequent risks encountered by travelers. Efficient interventions are needed to improve the understanding of the risks of STIs. We investigated the potential benefits of a motivational brief intervention (BI) and the provision of condoms on the engagement in unprotected casual sex. METHODS: 3-arm randomized controlled trial performed among single travelers aged 18-44 years visiting a travel clinic in Switzerland. The main outcomes were the prevalence of casual unprotected sexual intercourse and their predictors. RESULTS: 5148 eligible travelers were seen from 2006 to 2008. 1681 agreed to participate and 1115 subjects (66%) completed the study. 184/1115 (17%) had a casual sexual relationship abroad and overall 46/1115 (4.1%) had inconsistently protected sexual relations. Women (adjusted OR 2.7 [95%CI 1.4-5.6]) and travelers with a history of past STI (adjusted OR 2.8 [95%CI 1.1-7.4]) had more frequent casual sexual relationships without consistent protection. Regarding the effect of our intervention, the prevalence of subjects using condoms inconsistently was 28% (95%CI16-40) in the motivational BI group, 24% (95%CI10-37) in the condoms group and 24% (95%CI14-33) in the control group (p = 0.7). CONCLUSION: This study showed that a motivational brief intervention and/or the provision of free condoms did not modify risky sexual behavior of young travelers. The rate of inconsistently protected sexual relationships during travel was however lower than expected TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT01056536.

[Implementation of a coordinated action plan of indications and follow-up for alcohol dependent patients in the state of Vaud]. / Mise en place d'un réseau alcoologique coordonné d'indication et de suivi dans le canton de Vaud.

Alcohol dependence is a chronic disease with many consequences and needs long-term follow-up. The Public Health Service of the state of Vaud has decided to create a coordinated action plan of indications and follow-up for alcohol dependent patients covering the whole state. As described in this article, the aims of this action plan are to standardize the evaluation, the care and the follow-up for alcohol dependent patients, to improve the accessibility to care by promoting less intense care and to improve the continuity of care from inpatient treatment to ambulatory care. This action plan aims to allow a better accessibility to specialized care, to improve treatment adherence and a reduction of relapses.

[Motivational interviewing to help patients stop drinking]. / Comment motiver un patient pour qu'il arrête de boire?

Helping patients to change behavior concerning their drinking is a common task in primary care. This article examines the limitations of using the approach of giving advice and identifies concepts and methods, which offer the promise of improving the quality and effectiveness of consultations about alcohol use. The central role of ambivalence in alcohol dependent patients is explored and practical solutions to resolve ambivalence are described, considering the stages of change model.