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Behavioral Intervention to Prevent STDs among Minority Women in Texas

An Evidence-Based Practice

Description

Funded through a grant from the National Institute of Allergy and Infectious Disease, this intervention sought to prevent sexually transmitted disease (STD) infections among high-risk minority women. Women were recruited from the San Antonio, Texas area through the public health clinic system. Participants were African-American and Mexican-American women who were considered at high risk for infection (those who currently had a non-viral STD such as gonorrhea, chlamydia, syphilis, or trichomonas).

Women attended small-group interactive sessions, where they met once a week for three consecutive weeks. The groups consisted of five or six participants and a female facilitator--all of the same ethnicity. The sessions included games, behavior modeling, role play, watching videos, and active discussions. Difficult concepts for low-literacy populations were broken down clearly using graphic materials designed by the program.

Strategies for STD prevention included abstinence, monogamy among both partners, reduction in number of partners, compliance with treatment, and condom use. Facilitators emphasized the importance of reasonable and realistic risk-reduction strategies that the participants could incorporate into their own lives. Participants received incentive payments, a meal and a gift at each session.

Goal / Mission

The goal of the study was to prevent STDs in high-risk minority women through three culture-specific small group education and counseling sessions, delivered over time.

Impact

Reinfection rates of chlamydia and gonorrhea were significantly lower at each follow-up among participants in the small-group counseling sessions than in the control group. Integration of behavior-change theory with extensive qualitative data collected in target communities enabled the study to create culturally meaningful strategies to promote the recognition of risk and to stimulate motivation to effect personal change.

Results / Accomplishments

This randomized control trial enrolled 193 African-American and 424 Mexican-American women from January 1993 to July 1994. The control group received standard STD counseling; the study group received the small-group education sessions. Both groups of women were tested at baseline and at 6 and 12 months for gonorrhea and chlamydia, to see if the program was helping prevent re-infection.

The women who received the culture-specific interventions were significantly less likely to have gonorrheal or chlamydial infections at follow up than the control group (p=0.05 at 6 months, p=0.008 from 6- to 12-months, p=0.004 from baseline to 12-months).

Over time, the effects of the intervention persisted. The infection rate of the study group versus the control group was 34% less at 6 months, 49% less at 12 months, and 38% less overall.

About this Promising Practice

Organization(s)
University of Texas Health Science Center and the San Antonio Metropolitan Health District
Primary Contact
John Shields, Ph.D.
Sociometrics Corporation
170 State Street, Suite 260
Los Altos, CA 94022-2812
1-800-846-3475
jshields@socio.com
Topics
Health / Women's Health
Health / Immunizations & Infectious Diseases
Organization(s)
University of Texas Health Science Center and the San Antonio Metropolitan Health District
Source
Urban Institute
Date of publication
1/14/1999
Date of implementation
1993
Geographic Type
Urban
Location
Texas
For more details
Target Audience
Women, Racial/Ethnic Minorities
Michigan Health Improvement Alliance