SEPA III: An HIV Prevention Intervention to Reduce HIV Risk Among Hispanic Women

Purpose:

The adoption of HIV prevention behaviors involves a complex process for Hispanic women. Culturally-specific HIV prevention programs are needed to address the unique context of these women. Few culturally-tailored interventions for Hispanic women have been tested in community settings. This presentation will describe the design of a randomized controlled trial to analyze HIV prevention related outcomes of Hispanic women in SEPA, an evidence-based HIV risk reduction intervention delivered in a real world setting by community agency personnel, and characteristics of women enrolled in the study.

Methods:

Baseline data collected to test the effectiveness of the randomized clinical trial SEPA (Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/self-care). A total of 320 Hispanic women between 18 and 50 years old were enrolled in this study. Participants were recruited through outreach at the Florida Department of Health in Miami Dade County and at public places where Hispanic women go frequently (e.g., churches, supermarkets, community organizations). Assessors were female bilingual interviewers using a structured questionnaire that contained questions about HIV related factors. Assessments are completed at baseline (pre-randomization), and 6-months and 12-months post-baseline. Assessments were collected with a web-based research management software system (e-Velos). Hispanic women were randomized to 2 intervention conditions, SEPA and a delayed-intervention control group. The SEPA intervention is an HIV prevention program with 3 sessions. Group sessions were facilitated by agency personnel trained by study personnel, and on-going supervision was provided by the study personnel.

Results:

On average, participants were 35 years old (SD = 9.15), had 13 years of education (SD = 3.46). The majority (71%) were employed, and average monthly income was $1674 (SD = 1007). Women had been living in the U.S. for a mean of 8.34 years (SD = 8.28), and had high Hispanicism (M = 3.50, SD = 0.37), and low Americanism (M = 2.01, SD = 0.77). About two-thirds (68%) were living with a romantic partner, and over a third (37%) were married, with 15% single, 6% separated, and 4% divorced. Women reported few sexual partners in their lifetime (M = 6.48, SD = 19.15); and were mostly monogamous: (96%) had one main partner in the past 6 months, but only 11% had multiple partners in that time; 91% had one main partners in the previous 30 days, but only 6% had multiple partners in that time. Few (18%) women said they always used condoms during vaginal sex with their main partner over a 6-month periods. Of the women who had sex with other men in the last 6 months, only 13% reported always using condoms in the previous 6 months. In the 30 days before enrollment women said they used condoms 33% of the times they had vaginal sex with their main partner, and women who had sex with other man use condoms 51% of the time during vaginal sex. About 44% reported some physical violence (on the Conflict Tactics Scale), but only 4% were positive on the HITS violence screening tool.

Conclusion:

Baseline data showed that Hispanic women who enrolled in SEPA III are at risk of acquiring HIV. SEPA intervention may benefit these women through the reduction of HIV risk behaviors. This study is designed to test whether SEPA reduces HIV/STI risk behaviors and incidence of HIV/STI when delivered in a real world setting. If SEPA intervention proves to be effective, it will suggest that SEPA can be easily implemented in various settings to reach Hispanic women, and that SEPA could reach large numbers of women in an efficient cost-effective way.