title: Reduction in sexual risk behaviors and infection rates among African Americans and Mexican Americans.
abstract: BACKGROUND
  Project SAFE, a gender- and culture-specific cognitive-behavioral intervention, was one of the few interventions to have demonstrated a significant reduction in sexually transmitted infections in a randomized, controlled trial.
  
  
  OBJECTIVE
  We evaluated intervention efficacy in 379 Mexican Americans and 170 African Americans; and in a subset of 477 women, explored ethnic differences in the relationships over time between attitudes/beliefs about relationships, reported sexual behavior, and infection.
  
  
  METHODS
  Women were questioned intensively at baseline, 6, and 12 months. We used stratified analyses and multivariate regression to evaluate ethnic differences and the role of behavior in explaining ethnic differences in infection.
  
  
  RESULTS
  African Americans had higher overall infection rates (29.0% vs. 18.3%) than Mexican Americans, but the intervention efficacy was similar (odds ratios, 0.58 and 0.54, respectively). African Americans reported more douching after sex, less mutual monogamy, and more rapid partner turnover. However, Mexican Americans appeared slightly more likely to have sex with an untreated partner, and there was no difference in risky sex. African Americans reported greater difficulty finding partners and reported attitudes more compatible with nonmonogamy.
  
  
  CONCLUSIONS
  Despite substantial ethnic differences in attitudes/beliefs, behaviors, and infection rates, the intervention had a comparable impact on both Mexican American and African American.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, Texas 78229-3900, USA. kortej@uthscsa.edu
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Korte
authors.forename: Rochelle N
authors.initials: RN
authors.lastname: Shain
authors.forename: Alan E C
authors.initials: AE
authors.lastname: Holden
authors.forename: Jeanna M
authors.initials: JM
authors.lastname: Piper
authors.forename: Sondra T
authors.initials: ST
authors.lastname: Perdue
authors.forename: Jane D
authors.initials: JD
authors.lastname: Champion
authors.forename: Kyle
authors.initials: K
authors.lastname: Sterneckert
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D016018:Least-Squares Analysis; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D015397:Program Evaluation; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000208:ethnology* / Q000517:prevention & control*; D013781:Texas / Q000453:epidemiology