Efficacy of SEPA II: An HIV Risk Reduction Program Among Hispanic Women in Florida

Tuesday, 31 July 2012: 4:10 PM

Nilda (Nena) Peragallo, RN, DrPH, FAAN
Schol of Nursing and Health Studies, University of Miami, Coral Gables, FL
Rosa Maria Gonzalez-Guarda, PhD, MPH, RN, CPH
School of Nursing & Health Studies, University of Miami, Coral Gables, FL
Rosina Cianelli, PhD, MPH, RN, FAAN
Schol of Nursing and Health Studies, University of Miami; Pontificia Universidad Catolica de Chile, Coral Gables, FL
Natalia Villegas, MSN, RN
School of Nursing and Health Studies, University of Miami, Coral Gables, FL

Learning Objective 1: The learner will be able to identify the efficacy of SEPA II intervention in reducing HIV risk among Hispanic women in Florida.

Learning Objective 2: The learner will be able to identify and understand the importance of implementing culture-specific interventions that target populations at high risk of acquiring HIV.

Purpose : Although the U.S. is less affected from the feminization of HIV than other regions in the world (e.g., Africa and India), the incidence of HIV has remained relatively stable over the past 10 years among women, indicating little progress in curbing the epidemic among this population. Hispanic women in the U.S. are particularly at risk for HIV infection, with heterosexual intercourse the most common mode of transmission. HIV rates for Hispanics are 3.5 times as high as those of Caucasians. The feminization of HIV infection and the diversification of women in the U.S. have led to a call for the development and evaluation of gender and culturally specific HIV prevention strategies. This study evaluates the efficacy of SEPA (Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/Self-care), a culturally-specific HIV risk reduction group education intervention for Hispanic women in the U.S.

Methods: A randomized controlled trial with 548 Hispanic women (18 to50 years old) was conducted. Women completed structured interviews at baseline and 3, 6, and 12 months post-baseline. Women were assigned to SEPA (n = 274) or to a delayed-intervention control group (n = 274). SEPA is based on input from Hispanic women, Bandura's Social Cognitive Theory, and Freire’s Pedagogy of the Oppressed. SEPA II has five group sessions of two hours each. Each group had approximately 10-12 participants, a facilitator and co-facilitator. The groups were conducted in Spanish or English according to the preference of the participants.

 Results: Intent-to-treat generalized estimating equations analyses indicated that compared to controls, SEPA women increased condom use, HIV knowledge, behavioral intentions for HIV prevention, partner communication and community prevention. Also, SEPA women decreased Chlamydia rates and intimate partner violence.

Conclusion: Culturally-specific interventions have promise in preventing HIV for Hispanic women in the U.S. SEPA should be disseminated to community-based organizations for wide-scale use.