Evaluation of a sexual health approach to prevent HIV among low income, urban, primarily African American women: results of a randomized controlled trial.
This randomized controlled trial evaluated an innovative culturally specific sexual health intervention-targeting, but not limited to, low-income African American women-in which HIV and sexually transmitted disease prevention strategies were combined with comprehensive sexuality education. The intervention was delivered and evaluated in community-based settings to 218 participants randomly assigned to treatment or a no-treatment control group. Participants were interviewed at pretest and 3 and 9 months after the intervention to assess changes in both sexuality and HIV risk variables. The intervention was effective in improving sexual anatomy knowledge at both 3- and 9-month follow-up. For a subset of women engaging in unprotected sex at pretest, the intervention group reported an increase in positive attitudes toward the female condom at 9-month follow-up. Reasons for the weak treatment effect are discussed in the context of challenges inherent in conducting community-based research with high-risk populations and sensitive topics. Recommendations are provided for improving sample attrition, statistical power, and response bias and for altering the intervention so as to strengthen its impact.
Robinson
Beatrice Bean E
BB
University of Minnesota Medical School, Program in Human Sexuality, Department of Family Practice and Community Health, Minneapolis 55454, USA. brobinsn@famprac.umn.edu
Uhl
Gary
G
Miner
Michael
M
Bockting
Walter O
WO
Scheltema
Karen E
KE
Rosser
B R Simon
BR
Westover
Bonita
B
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education* / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control*; D006801:Humans; D011203:Poverty; D011314:Preventive Health Services / Q000458:organization & administration*; D012725:Sexual Behavior / Q000208:ethnology*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D040241:Social Marketing; D014481:United States / Q000453:epidemiology; D014504:Urban Health