Program

Oct 26, 2007

OVERVIEW

Sistering, Informing, Healing,
Loving, and Empowering (SiHLE) is an HIV prevention
intervention for African American females, aged 14-18. In a random
assignment study, females assigned to take part in the SiHLE
intervention were compared with females assigned to a control intervention that
dealt with nutrition and exercise. At both the six-month and the
twelve-month follow-ups, SiHLE females reported
significantly more consistent condom use than did control group females. SiHLE females were marginally less likely to report having
become pregnant during the follow-up period and were less likely to report
having acquired new sexual partners in the month leading up to the follow-up assessment.
SiHLE females were also significantly less likely to
have acquired Chlamydia during the follow-up period, but were not less likely
to have acquired trichomonas or gonorrhea.

DESCRIPTION OF PROGRAM

Target population: sexually experienced African
American females, aged 14-18

Sistering, Informing, Healing,
Loving, and Empowering (SiHLE) is an HIV prevention
intervention for African American females, aged 14-18. Social cognitive
theory and the theory of gender and power informed the development of this
intervention. The intervention consists of four four-hour sessions.
The first session emphasizes ethnic and gender pride. The second session
enhances participant awareness of HIV risk reduction strategies, including
abstaining from sex, using condoms consistently, and having fewer sex
partners. The third session seeks to enhance participants’ negotiation
and refusal skills through role-plays and cognitive rehearsals. Condom
use skills are also taught during this session. The fourth session
emphasizes the importance of healthy relationships.

EVALUATION(S) OF PROGRAM

DiClemente, R. J., Wingood, G. M., Harrington, K. F., et al. (2004).Efficacy of an HIV prevention intervention for
African American adolescent girls: A randomized controlled trial. Journal
of the American Medical Association, 292
, 171-179.

Evaluated population: 522 African American females
between the ages of 14 and 18 served as the study sample for this
investigation. Subjects were recruited from four community health
agencies between December 1996 and April 1999. In order to be eligible
for the study, females had to have engaged in vaginal intercourse during the
preceding six months.

Approach: Subjects were randomly assigned to the
treatment group or the control group. Subjects assigned to the treatment
group took part in the SiHLE intervention over the
course of four consecutive Saturdays. The intervention was delivered to
groups of 10 to 12 subjects by a trained African American female health
educator and two African American peer educators. Subjects assigned to
the control group took part in an intervention similar in format to SiHLE, but unrelated to sexual health. The control
intervention included two sessions on nutrition and two sessions on exercise.

All subjects completed baseline assessments before the
four-week intervention period began. Follow-up assessments occurred six
and twelve months after the intervention period. At each assessment,
subjects completed a self-administered questionnaire, took part in an interview
on sexual behaviors, demonstrated their condom use skills, and provided vaginal
swab specimens that were analyzed for sexually transmitted diseases.
Attrition was low (about 10%).

Results: At both the six-month and the twelve-month
follow-ups, SiHLE females reported significantly more
consistent condom use than did control group females. SiHLE
females were marginally less likely to report having become pregnant during the
follow-up period and were less likely to report having acquired new sexual
partners in the month leading up to the follow-up assessment. Vaginal
swabs revealed that SiHLE females were significantly
less likely to have acquired Chlamydia, but were not less likely to have
acquired trichomonas or gonorrhea.

SiHLE females demonstrated greater
condom use proficiency than control females at both follow-ups on the condom
use demonstration task. SiHLE females also had
higher condom-use self-efficacy and higher HIV prevention knowledge
scores. Compared with control females, SiHLE
females reported perceiving fewer barriers to condom use, having more favorable
attitudes towards condoms, and having more frequent discussions with their sex
partners about HIV prevention.

SOURCES FOR MORE INFORMATION

Curriculum materials are under development. Contact
Cynthia Prather for details:

CPrather@cdc.gov

References:

DiClemente, R. J., Wingood, G. M., Harrington, K. F., et al. (2004). Efficacy of an HIV prevention intervention for
African American adolescent girls: A randomized controlled trial. Journal
of the American Medical Association, 292
, 171-179.

KEYWORDS: Adolescence (12-17), Youth (16+), Young Adulthood
(17-24), High-Risk, High School, Gender-specific (female only), Black or
African American, Clinic-based, Community-based, Urban, Life Skills Training,
Reproductive Health, Sexual Initiation, Risky Sex, STD/HIV/AIDS

Program information last updated on
10/26/07.