Effectiveness of alcohol advise in sexual health clinics

Are sexual health (sexually transmitted infection) clinics a suitable venue to give advise on alcohol abuse? A recently published randomised controlled trial of rapid screening and advise in three London-based sexual health clinics showed little effect of screening and advise on alcohol consumption, or unsafe sexual behaviour six months later.

802 people aged 19 years or over who attended one of three sexual health clinics and were drinking excessively were randomised to either brief advice or control treatment. Brief advice consisted of feedback on alcohol and health, written information and an offer of an appointment with an Alcohol Health Worker. Control participants received a leaflet on health and lifestyle.

The primary outcome was mean weekly alcohol consumption during the previous 90 days measured 6 months after randomisation. The main secondary outcome was unprotected sex during this period.

Among the 402 randomised to brief advice, the adjusted mean difference in alcohol consumption at 6 months was −2.33 units per week (95% CI −4.69 to 0.03, p=0.053) among those in the active compared to the control arm of the trial.

Unprotected sex was reported by 53% of those who received brief advice, and 59% controls (p=0.496).

In a linked leading article in the journal Sexually Transmitted Infections Keith Radcliffe and Nicola Thornley review the links between alcohol misuse and unsafe sexual practices. They report conflicting information as to the benefits of behaviour intervensions, both in terms of reduction in the consumption of alcohol and in unsafe sexual behaviour.

The current study adds to the growing literature on the difficulties of behaviour intervention in having lasting effects on behaviour changes, whether it is sexual or eating habits.

Clearly more work is needed to help translate knowledge into behaviour.


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