SPECIAL SESSION: Reducing HIV Health Disparities Among Hispanics Through Culturally Tailored Intervention Science

Description/Overview: Introduction: Globally, HIV continues to be one of the leading causes of death. At the end of 2012, there were more than 35 million people living with HIV worldwide. In the U.S., the incidence of HIV is increasing more rapidly among racial and ethnic minorities, representing over 72% of new HIV cases and 65% of those currently living with HIV. Interventions to prevent HIV are needed for Hispanic women at all ages. SEPA (Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/self-care), an HIV prevention intervention for Hispanic women has been demonstrated to be efficacious for decreasing HIV risk behaviors. The purpose of this presentation is to discuss a program of research to develop, test, adapt and disseminate SEPA. The aims of this presentation are to: (1) describe the development and impact of the SEPA intervention and its successful implementation in different settings and diverse Hispanic groups, and (2) discuss future opportunities and challenges in research with diverse communities. Methods: SEPA is an evidenced-based HIV risk reduction intervention initially designed for Mexican and Puerto Rican women living in Chicago. In the first SEPA randomized controlled trial (SEPA I), 657 Hispanic women between 18 and 44 years old were assigned to SEPA or to a delayed-intervention control group. Women completed structured interviews at baseline and 3 and 6 months post-baseline. SEPA was culturally tailored and consisted of six weekly sessions, two hours each. The groups were conducted in Spanish or English according to participants’ preference. After this trial, SEPA was successfully adapted and implemented in different settings and among diverse Hispanic communities, including: “Mano a Mano”, an initiative for women, men, and health care workers in Chile (R01TW-03-007769-5; RO1007674-5; R01TW006977); I-STIPI, a web-based intervention for Chilean young women; SEPA-O, for Hispanic women age 50 and above; and SEPA II, for Hispanic women in South Florida. SEPA III, an effectiveness trial, is being implemented in a real world setting by community agency personnel to reduce the gap between research and practice. Much of the recent work on SEPA is conducted within the Center of Excellence for Health Disparities Research: El Centro (NIH/MCHMD P60MD002266). Results: In SEPA I, SEPA was found to increase condom use and improve HIV knowledge, partner communication and risk reduction behavioral intentions, and to decrease perceived barriers to condom use. Similar results were reported in the second randomized clinical trial, SEPA II, and women who received the SEPA intervention also reported a reduction in intimate partner violence. The adaptations of SEPA have also had an impact in HIV prevention among diverse Hispanic groups. These adaptations have maintained the core elements of the original SEPA intervention. Conclusion: SEPA has been shown to be efficacious for reducing HIV risk among Hispanic women and provides evidence that HIV/AIDS prevention interventions must be developed and disseminated in the community and culturally tailored to the targeted population of the intended program. SEPA has contributed to research on health disparities and HIV prevention by providing a culturally specific and evidence based intervention that can be implemented in different settings.