A Brief Skill-Building Program Can Reduce STD
or HIV Risk among Inner-City African American Women
A brief skill-building program on practices to reduce exposure
to sexually transmitted disease (STD) and HIV improved the self-reported
protective behaviors of inner-city black women for up to one year
and actually decreased their risk of acquiring an STD, according
to a study appearing in the June 2007 issue of the American
Journal of Public Health. The women received the program from
specially trained nurses either individually or in small group
sessions at an inner-city women’s health clinic. The study was
conducted as part of the “Sister to Sister: The Black Women’s Health
Project,” funded by the National Institute of Nursing Research
(NINR), a component of the National Institutes of Health (NIH).
“Teaching healthy behaviors is an important part of what nurses
do in the primary health care setting, and this research suggests
a direct link between health behavior and disease prevention,” said
Patricia A. Grady, PhD, RN, Director of NINR.
Added Loretta Sweet Jemmott, Ph.D., RN, nursing professor at the
University of Pennsylvania and lead investigator of the study, “Nurses
working with inner-city African American women can incorporate
this brief, evidence-based preventive intervention into their routine
practice.”
The findings address a significant area of health disparity. According
to Dr. Jemmott, African American women in the U.S. suffer disproportionately
high rates of several STDs. In addition, African American women
have an elevated incidence of HIV/AIDS, a disease often transmitted
to women through heterosexual contact, and the leading cause of
death among African American women aged 25 to 34 years.
This study was designed to identify effective single-session STD
or HIV risk reduction interventions for inner-city African American
women. Researchers evaluated four separate behavioral interventions
among a group of 564 sexually experienced African American women
from an inner-city women’s health clinic. The women ranged in age
from 18 to 45 years, and nearly 90 percent reported being sexually
active within the last 3 months. At baseline, less than one-quarter
reported consistent use of condoms, and one in five tested positive
for an STD, either gonorrhea, trichomoniasis, or chlamydia.
The nurse-led interventions were presented in two formats: information-only,
or information plus behavioral skill-building. The information-only
intervention involved reviewing and discussing a brochure on STD/HIV
prevention and safe sex practices. The behavioral skill-building
program included review of the STD/HIV brochure, while adding video
clips, practice with applying a condom, and role-playing of negotiations
for condom use with a sexual partner. Participants received the
interventions either in one-on-one sessions lasting 20 minutes,
or in small group sessions lasting roughly three hours.
At a 12-month follow-up, women who received the skill-building
program, either individually or in a group, reported a higher proportion
of condom use during sexual intercourse over the previous three
months and were more likely to report using a condom during their
most recent sexual episode than women who received information
only. In addition, compared to a control group, women from the
skill-building groups were less likely to test positive for an
STD.
“Nurses are key health professionals in primary care, well-positioned
to reach at-risk and underserved populations,” said Dr. Jemmott. “The
women in this study were encouraged to respect and protect themselves,
both for their own sake and for their family and community. We
need to make greater effort to reduce the spread of STDs, and especially
HIV, which has already killed too many African American women and
orphaned too many children.”
According to Dr. Grady, “This study adds a significant piece to
the effort to improve the protective health behaviors of inner-city
African American women, a population that is often underserved
in our country. This behavioral intervention can help women take
better control of their lives and decrease the spread of many diseases,
including HIV/AIDS.”
Dr. Jemmott recently received funding from the Replicating Effective
Programs initiative of the Centers for Disease Control and Prevention.
This initiative promotes the translation of effective programs
into clinical practice. Dr. Jemmott and her team are now collaborating
with Family Planning Clinics in Philadelphia to determine the feasibility
of integrating their 20-minute, one-on-one STD/HIV intervention
into these clinical sites.
The primary mission of the NINR, one of 27 Institutes and Centers
at the National Institutes of Health, is to support clinical and
basic research and establish a scientific basis for the care of
individuals across the life span. For additional information, visit
the NINR web site at www.ninr.nih.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.
|