title: Evaluation of a sexual health approach to prevent HIV among low income, urban, primarily African American women: results of a randomized controlled trial.
abstract: 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.
authors.affiliation: University of Minnesota Medical School, Program in Human Sexuality, Department of Family Practice and Community Health, Minneapolis 55454, USA. brobinsn@famprac.umn.edu
authors.forename: Beatrice Bean E
authors.initials: BB
authors.lastname: Robinson
authors.forename: Gary
authors.initials: G
authors.lastname: Uhl
authors.forename: Michael
authors.initials: M
authors.lastname: Miner
authors.forename: Walter O
authors.initials: WO
authors.lastname: Bockting
authors.forename: Karen E
authors.initials: KE
authors.lastname: Scheltema
authors.forename: B R Simon
authors.initials: BR
authors.lastname: Rosser
authors.forename: Bonita
authors.initials: B
authors.lastname: Westover
mesh_terms: 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