Program

Nov 17, 2015

OVERVIEW

The Respecting and Protecting Relationships program focuses on educating parenting couples and encouraging them to work together and support one another to engage in protected sexual intercourse.  The intervention is a 12-hour curriculum focusing on discussion, reflection, and skills-building.  An experimental evaluation found that, over 6 months, those in the intervention were less likely to have engaged in unprotected intercourse in the previous 3 months, were more likely to intend to use condoms in future sexual encounters, and reported having more HIV/AIDS knowledge; however, only impacts on HIV/AIDS knowledge were found at the 12 month follow up.

DESCRIPTION OF PROGRAM

Target population: Adolescent and young adult Latino couples, aged 14 to 25 who are co-parenting a young child

The “Respecting and Protecting our Relationships” program is a theory-based HIV prevention intervention.  The program aims to reduce the high teenage birth rate and STI rates amongst adolescent Latinos.  It focuses on engaging couples in conversations and skills practice around safe sex, how couples can support one another, and uses discussions about how safe sex protects the family to motivate engagement in safer behavior.  It is a 12-hour (6 sessions) program that uses facilitated discussion, writing, interactive activities, and skills-building to discuss and learn about gender, power, relationship violence, HIV, and condom use.  The curriculum incorporates cultural teachings throughout to make it relevant to Latino youth specifically.  Community-based organizations and hospitals host small groups (one to five couples) of adolescents and young adults who are taught the curriculum by bilingual facilitators – who receive approximately 40 hours of extensive didactic and experiential training. Condom use in the last three months, intention to use condoms in the future, and HIV knowledge are the specific outcomes of interest.

EVALUATION OF PROGRAM

Koniak-Griffin, D., Lesser, J., Takayanagi, S., and Cumberland, W. (2011) Couple-Focused Human Immunodeficiency Virus Prevention for Young Latino Parents.  JAMA Pediatrics, 165, 306-12.

Evaluated population: Mothers were recruited from WIC programs, alternative schools, community-based service organizations, and clinics and were eligible if they were between the ages of 14 and 25, in a relationship, and parenting a child who was 3 months or older.  If they consented, their partners were approached and needed to meet the same criteria.  A total of 168 couples (336 individuals) were included in the study.  Eighty-two couples were randomly assigned to the intervention group and 86 to the control group (which received one session, an hour and a half lecture considered to be usual care in the National Institute of Mental Health).  The median age of the females and males was 18.5 years and 20.4 years respectively.  Most had not graduated from high school and had been in their relationships for approximately 3 years.  Women had had on average three sexual partners over their lifetime and men had had six.  There were no significant differences between the intervention and control groups suggesting randomization was effective at creating two similar groups.

Approach: Randomization was conducted at the couple level and clustered by geography.  Data were collected at baseline in the small groups and then at 3, 6, and 12 months individually. Individual interviews typically took place at each respondent’s home with partner interviews conducted separately but at the same time.  Participants received $15 for each class that they attended and $25 for each questionnaire.  Ninety percent of respondents participated in eight or more sessions and 70 percent participated in all 12.  Seventy-five percent of respondents completed each of the follow-up questionnaires though they were not always the exact same people.  A 75 percent response rate was achieved at 12 months, and 336 individuals were included in the analyses; missing data at each time point was addressed with multiple imputation.

Results: Results are presented for three outcomes: probability of unprotected sex in the previous three months, intent to use condoms, and knowledge about HIV/AIDS.  The respondents in the intervention groups were significantly less likely to have had unprotected sex in the previous 3 months at the 6-month follow-up but this result was reversed by the 12-month follow-up so that respondents in the intervention group were more likely to have had unprotected sex in the last 3 months.  There was no change over time in the control group’s behaviors.  Respondents in the intervention group were more likely to report an intention to use condoms at the 6-month follow up though this increase in intent was also not sustained over time.  Women were more likely to report an intention to use condoms than men.  Respondents in the control group experienced no change in their intent to use condoms over time.  Knowledge of HIV/AIDS increased in both groups at the 6-month follow-up, and there was no significant difference between the two groups.  At the 12-month follow-up, the control group had less HIV/AIDS knowledge, and there were significant differences between the groups at this time point.  Women, again, were more likely to report more HIV/AIDS knowledge.

SOURCES FOR MORE INFORMATION

References

Koniak-Griffin, D., Lesser, J., Takayanagi, S., and Cumberland, W. (2011) Couple-Focused Human Immunodeficiency Virus Prevention for Young Latino Parents.  JAMA Pediatrics, 165, 306-12.

Contact Information

National Latino Fatherhood and Family Institute

1550 The Alameda, Suite 303

San Jose, CA 95126-2304

KEYWORDS: Hispanic/Latino, STD/HIV/AIDS, urban, adolescents, youth, young adults, males and females, adolescent mothers, life skills, teen pregnancy, condom use and contraception, family structure/marriage

Program information last updated on 11/17/15

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