Program

Nov 07, 2012

OVERVIEW

Sisters Saving Sisters is a skill-based program designed to reduce the risk of unprotected sexual intercourse among sexually experienced Latino and black adolescent females. The program provides culturally- and developmentally-appropriate small group sessions that focus on HIV and sexually transmitted disease (STD) risk reduction.

An experimental evaluation of the Sisters Saving Sisters program found that participation in the program was associated with a lower frequency of unprotected sex and of unprotected sex while intoxicated, fewer sexual partners, and lower STD rates at one or more of the intervention’s follow-ups.

DESCRIPTION OF PROGRAM

Target population: Sexually experienced black and Latino adolescent girls

The Sisters Saving Sisters program is a brief, small-group program that aims to promote HIV/STD risk reduction among black and Latina adolescent girls.  This skill-based STD/HIV intervention provides three, 250-minute interventions with information on HIV and STDs and is designed to be both culturally and developmentally appropriate for the participants.  Participants meet in small groups of between two and ten adolescent girls and complete activities such as engaging in group discussions, watching videos, role playing, viewing condom use demonstrations, practicing condom use on anatomical models, and participating in related games and experiential exercises.  Program sessions are designed to address beliefs and knowledge about personal HIV/STD vulnerabilities, HIV/STD vulnerabilities among minority populations, HIV/STD risk reduction, condom use, condom-use negotiation, and barriers to condom use (such as alcohol and drug use) as well as responses to these challenges.

EVALUATION OF PROGRAM

Jemmott, J. B., Jemmott, L. S., Braverman, P. K., & Fong, G. T. (2005). HIV/STD risk reduction interventions for black and Latino adolescent girls at an adolescent medicine center: A randomized control trial. Archives of Pediatrics and Adolescent Medicine, 159, 440-449.

Evaluated population:  The evaluated population included 682 sexually-experienced adolescent girls (463 black and 219 Latino) who were recruited from an adolescent medicine clinic in Philadelphia, PA. Of the Latino participants, 93 percent were Puerto Rican. The participants were ages 12 to 19 (mean age of 15.5), and all could read and speak English. Participants were eligible for the study if they were not currently pregnant and were not planning to move from the area of the clinic

Approach: Participants were recruited from a low-income, inner-city adolescent medical clinic in a hospital in Philadelphia, PA. All participants had volunteered for a “Women’s Health Project” initiative to reduce health risks in the black and Latino populations. During their bi-annual STD screenings (which was a component of the latter initiative) the girls were referred to the study; those who were eligible and agreed to participate were stratified by age and then randomly assigned to one of two treatment groups or a control group.  The first treatment group received the Sisters Saving Sisters program (the skill-based HIV/STD risk-reduction program) and the second received in information-based HIV/STD risk-reduction program that focused on the messages about sex and condoms that the girls received (this treatment did not include skill-based exercises, such as practicing condom use on anatomical models).  To ensure that program impacts were not merely attributable to group interactions and attention that would have come from the two treatment groups, control group received a “health-promotion” intervention that focused on behavioral risk reduction for heart disease, cancer, and stroke.  Participants received $40 for participating in the programs.

The primary outcome of interest in this evaluation was the number of days that the adolescent reported having unprotected sex in the prior three months.  The secondary outcomes of interest included number of partners in the prior three months, whether the participant had multiple partners in the prior three month, the number of days in the prior three months that they had sex while under the influence of drugs or alcohol, the number of days in the prior three months that they had unprotected sex while under the influence of drugs or alcohol, and STD infection (having a positive STD test). Self-reported data for each of these measures were collected at baseline and then at 3, 6, and 12 months after the intervention (and STD tests for gonorrhea, Chlamydia, and trichomoniasis were administered at 6 and 12 months).

Results: At the 12-month follow-up, those in the Sisters Saving Sisters group reported fewer days in the prior three months that they had sex without a condom than those in either the information-based group or the control group (however, there were no differences between groups at the 3- or 6-month follow-ups).

Additionally, compared with the control group at the 12-month follow-up, those in the Sisters Saving Sisters group reported few partners in the prior three months, were less likely to report having multiple partnerships in the prior three months, had fewer instances of unprotected sex under the influence of drugs or alcohol in the prior three months, and were marginally less likely to test positive for an STD, compared with the control group.  Again, none of these impacts were significant at the 3- or 6-month follow-ups.  On the other hand, at the 3- and 6-month follow-ups, those in the Sisters Saving Sisters group fewer instances of sex (unprotected or protected) under the influence of drugs or alcohol in the prior three months than those in the control group. And those in the Sisters Saving Sisters group also reported fewer instances of sex under the influence than those in the information-based group at the 3-month follow-up.

Significant impacts were also reported for theory-driven mediators at post-test, including HIV/STD knowledge, condom use knowledge, intentions, hedonistic beliefs, impulse control beliefs, and technical skills beliefs relative to control, as well as impacts on condom use knowledge relative to girls in the information-based treatment groups.

An evaluation of program impacts by race/ethnicity revealed that the Sisters Saving Sisters program was more effective among Latinas than among blacks in increasing condom negotiation beliefs and technical skill beliefs compared with the control group and in increasing condom negotiation beliefs compared with the information-based intervention.  On the other hand, the program was less effective among Latinas than among blacks at increasing HIV/STD knowledge than the information-based program.

SOURCES FOR MORE INFORMATION

References:

Jemmott, J. B., Jemmott, L. S., Braverman, P. K., & Fong, G. T. (2005). HIV/STD risk reduction interventions for black and Latino adolescent girls at an adolescent medicine center: A randomized control trial. Archives of Pediatrics and Adolescent Medicine, 159, 440-449.

Program information and curriculum materials available at:

http://www.selectmedia.org/programs/sisters.html

KEYWORDS: Adolescents (12-17), Youth (16+), Young Adults (1-24), Female Only, Black/African American, Hispanic/Latino, Urban, Clinic/Provider-Based, STD/HIV/AIDS, Sexual Activity, Condom Use and Contraception

Program information last updated on 11/7/12.