Paper
Friday, July 15, 2005
Modifying Risk Behavior of Minority Adolescent Women With STD
Jane Dimmitt Champion, PhD, FNP1, R. N. Shain, PhD2, J. M. Piper, MD2, J. Korte, PhD3, and A. Holden, MA3. (1) Department of Family Nursing, UTHSCSA, San Antonio, TX, USA, (2) Department of Obstetrics and Gynecology, The Univ of Texas Health Science Center at San Antonio, San Antonio, TX, USA, (3) Department of Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| Learning Objective #1: Describe the process for development of a cognitive behavioral intervention for prevention of STD, abuse, and unwanted pregnancy among minority adolescent women |
| Learning Objective #2: Describe the preliminary outcomes of a control-randomized trial of a behavioral intervention for sexual risk reduction for minority adolescents with STD and abuse history |
Background: This study builds on behavioral interventions developed in the studies, “Modifying STD Risk Behavior among Minority Women.” These studies are unique in that they designed and evaluated culturally relevant, minority-women-specific interventions based upon the AIDS Risk Reduction Model and were shown to be effective through controlled randomized trials. These interventions are grounded in knowledge of the target populations' behavior and culture and use STD and detailed measures of sexual behavior as primary outcome variables. Results of the first trial demonstrated participants receiving intervention were significantly less likely to be re-infected with STD. Although the intervention was successful with the sample as a whole, sexually abused adolescents were not helped. Subsequent studies indicated physically or sexually abused adolescents who used drugs or alcohol had the highest STD and unintended pregnancy rates and were not benefiting from the intervention. This study focuses on reducing rates of abuse recurrence, STD/HIV and unintended pregnancy among these women by changing high-risk sexual behaviors, decreasing substance use and encouraging contraception. Objective: Expand risk-reduction interventions created in previous studies to further increase intervention efficacy for this particularly vulnerable, high-risk group. Methods: An adolescent intervention (n=70) was pilot-tested in developmental studies. A controlled randomized trial for Mexican-American and African-American adolescent women with STD and a history of abuse (n=600) is in progress. Results: Preliminary findings indicate greater contraception and lower sexual risk behaviors, substance use, abuse recurrence, unintended pregnancy and STD rates than previous studies. Conclusions: There is a need for community-based, culturally sensitive, cognitive-behavioral interventions to reduce sexual risk behavior among adolescent women for prevention of STD/HIV, unintended pregnancy and abuse.