Importance: Black teenaged women have disproportionately high rates of unintended pregnancy (UTP) and sexually transmitted infections (STI). Internet-based interventions can be delivered to large groups of people in a relatively inexpensive manner. Objective: The purpose of this randomized trial was to examine the efficacy of an adaptation of a theory- and evidence-based UTP/STI prevention intervention for older teens and for internet delivery. Design: A randomized, attention-controlled trial. Setting: Participants were recruited from minority-serving institutions and community events in New Orleans, Louisiana. Participants: Black women aged 18-19 who were not pregnant nor seeking to become pregnant were enrolled (n=637). Main outcomes and measures: Participants were randomized to an 8-session intervention or attention control and were followed at 6- and 12-months post-intervention to determine if the use of reliable contraception, dual methods, intention to use condoms, and intention to use reliable contraception were higher among women in the intervention arm compared to controls. Pregnancy and STI rates were also compared. Results: Overall, at baseline, reliable contraception was 54.8% and dual protection was 29.4% and the prevalence of STI was 11.1%. Participants were similar by arm. Participation and follow-up rates were excellent (60.9% and 80.3%). At 6 months, all outcomes were improved in intervention compared to control, but this effect waned by 12 months. Conclusion and Relevance: The intervention was efficacious for increasing self-reported pregnancy and STI prevention behavior and intentions and lower trends for pregnancy and STIs were observed in this group which decreased over time suggesting the need for a booster.

The authors have declared no competing interest.

NCT01579617

This study was funded by Office of Adolescent Health, U.S. Department of Health & Human Services (HHS)

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