The proposed study's overarching goal is to reduce the ethnic disparities in HIV between Hispanic and non-Hispanic women. This goal will be accomplished by two aims:
Aim 1 is to establish a novel and effective partnership to improve minority health by integrating SEPA (i.e., Salud, Educacion, Prevencion y Autocuidado;Health, Education, Prevention and Self-Care) an evidenced based, HIV preventive intervention into community setting while assessing agency and facilitator characteristics and readiness for practice improvement, implementation, fidelity, and sustainability;
and Aim 2 is to evaluate the effectiveness of SEPA to increase HIV prevention behaviors and to reduce the incidence of STIs for Hispanic women when delivered in a real-world setting by community agency personnel. 300 Spanish-speaking Hispanic women between the ages of 18 and 50 who are sexually active will be recruited from one of four Miami-Dade County Public Health Department sites and randomized to either SEPA or a Wait-List Control condition. SEPA has been evaluated and found to be efficacious in two separate randomized controlled trials. In the first study (Peragallo et al., 2005), SEPA was shown to be efficacious relative to a Wait List Control condition in increasing the frequency of condom use, increasing partner communication regarding sex, and increasing HIV knowledge. In the second study (Peragallo et al., 2011), SEPA was efficacious (relative to Wait List Control) in reducing the incidence of STIs, in increasing the frequency of condom use, increasing partner communication, reducing intimate partner violence, and decreasing alcohol use. Partner communication regarding sex mediated the effects of the intervention on frequency of condom use. Hierarchical Linear Modeling (HLM) will be used to test (HI a): SEPA will be more effective relative to Wait List Control in reducing unprotected sexual behavior (defined as frequency of condom use in the past 90 days) over time. Logistic Regression will be used to test (H2a): SEPA will be more effective relative to Wait List Control in reducing STI incidence (specifically, the incidence of Neisseria gonorrhea. Chlamydia trachomatis, and Syphilis). Additionally, HLM and logistic regression, respectively, will be used to determine whether (H1b): The effect of SEPA on unprotected sexual behavior will be partially mediated by improvements in sexual communication with partner;and (H2b) The effect of SEPA on STI incidence will be partially mediated by improvements in sexual communication with partner and reductions in unprotected sexual behavior.
Hispanic women are at high risk for HIV and other sexually transmitted infections. There is a paucity of empirically supported interventions to address these health conditions for this group. The proposed study will test an intervention designed for Hispanic women as delivered in a community setting.
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