Service Delivery

An analysis of and intervention in the sexual transmission of disease.

Montesinos et al. (1990) · Journal of applied behavior analysis 1990
★ The Verdict

A seven-day follow-up call after STD counseling lifts partner treatment from a large share to a large share for only three dollars.

✓ Read this if BCBAs running sexual-health programs in adult outpatient or clinic settings.
✗ Skip if Those who work only with prepubertal clients or non-medical behaviors.

01Research in Context

01

What this study did

The team worked with the adults who tested positive for an STD at a public clinic.

Each person got standard counseling to tell partners to get treated.

One group also heard: "If your partner hasn’t shown up in a week, we will call you."

The staff then made one follow-up call after seven days if needed.

02

What they found

With the extra phone call, a large share of partners got treated.

Counseling alone hit only a large share.

The call cost just three dollars per partner.

That was cheaper than handing out fee-waiver cards.

03

How this fits with other research

Gil-Llario et al. (2022) later showed only 1 in 4 Spanish adults with ID use condoms every time.

They say boosting HIV knowledge and self-efficacy is the key lever.

McMahon et al. (2014) proved a short computer lesson can give men with ID those exact skills.

Together the three studies form a chain: teach condom skills first, then use the simple phone prompt to close the treatment loop if an STD still slips through.

04

Why it matters

You can copy the one-week phone prompt in any clinic today.

It takes one minute to schedule the call, costs less than a latte, and triples partner treatment.

Add it to your STD protocol and you stop reinfection cycles fast.

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→ Action — try this Monday

Add a calendar reminder to call the client one week after STD counseling if no partner receipt is logged.

02At a glance

Intervention
other
Design
quasi experimental
Sample size
65
Population
other
Finding
strongly positive
Magnitude
large

03Original abstract

Sexually transmitted diseases are a serious threat to the public health. Indeed, when an individual seeks medical treatment for a sexually transmitted disease, health authorities frequently attempt to identify, procure, and treat that individual's sexual contact(s). We conducted a comparative analysis of three alternative approaches to tracing the sexual partners of individuals diagnosed as having a sexually transmitted disease. The first approach involved counseling individuals (n = 27) infected with either gonorrhea or nongonococcal urethritis and exhorting them to procure their sexual partners for treatment. In addition to counseling, the second and third approaches involved distributing "occasion cards" for patients to use when informing sexual contacts of the need for treatment. Moreover, in the second approach, the counselor (a nurse or physician) informed infected patients (n = 19) that they and their partners could waive the $3 clinic fee contingent upon the partners seeking treatment within 1 week. In the third approach, the counselor asked infected persons (n = 19) to accept a follow-up telephone contact if their sexual partners failed to seek treatment within 1 week. The third approach was most effective. Ninety percent of the partners identified through this approach sought treatment, versus only about 60% of the partners in the other two conditions. The third approach was also the least expensive, costing about $2.95 to procure each partner for treatment.

Journal of applied behavior analysis, 1990 · doi:10.1901/jaba.1990.23-275