Efficacy of SEPA Intervention in HIV Risk Reduction and Intimate Partner Violence

Friday, 26 July 2013: 10:35 AM

Nilda (Nena) Peragallo, DrPH, RN, FAAN
Schol of Nursing and Health Studies, University of Miami, Coral Gables, FL
Rosa Maria Gonzalez, RN, MSN, MPH
Interdepartmental 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, PhD, MSN, RN
School of Nursing and Health Studies, University of Miami, Coral Gables, FL

Learning Objective 1: Identify the efficacy of SEPA intervention in reducing HIV risky behaviors and Intimate partner violence (IPV) among Hispanic women in Florida, USA.

Learning Objective 2: Identify and understand the importance of including intimate partner violence among populations at high risk of acquiring HIV.

Purpose: Hispanic women in the U.S. are particularly at risk for HIV infection. Various factors increase HIV risk for Hispanic women creating a unique configuration for HIV risk among Hispanic women. Intimate partner violence (IPV) is a risk factor that it can be particularly devastating among Hispanic women lacking access to or knowledge of relevant social services. 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 that include IPV reduction and prevention. This study evaluates the efficacy of SEPA (Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/Self-care), a culturally-specific HIV risk reduction intervention to reduce HIV infection rates among Hispanic women.


Methods: A randomized controlled trial with 548 Hispanic women (18 to 50 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 II has five group sessions of two hours each. One session was centered in IPV reduction. SEPA is based on input from Hispanic women, Bandura's Social Cognitive Theory, and Freire’s Pedagogy of the Oppressed. Each group had approximately 10-12 participants, a facilitator and co-facilitator. The groups were conducted in Spanish or English according to participants’ preference.

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

Conclusion: SEPA should be disseminated to community-based organizations for wide-scale use. SEPA reduced IPV, making it a culturally-specific HIV prevention program to reduce IPV. SEPA simultaneously addressed multiple and interrelated health disparities experienced by Hispanic women, which potentiates the public health significance of SEPA.