This project focuses on identifying and understanding behavior patterns of Mexican-American women, attending inner-city clinics, that are either directly or indirectly related to STD transmission. Its primary goal is to develop and evaluate a culturally appropriate STD/AIDS educational intervention for use in clinics. The proposed work builds on 1) a CDC sponsored project involving qualitative data collection with minority males and females and the development and evaluation of STD/AIDS interventions for minority males and 2) an existing educational intervention for female partners of IV drug using men. The time and cost of intervention and instrument development for this project will be reduced as a result of the already completed work.
Specific aims are: 1) To supplement qualitative data already collected in prior projects; 2) To adapt theory-driven STD/AIDS educational interventions (the CDC project will be using the AIDS Risk Reduction Model as a conceptual framework) and evaluation instruments to the study population using results of qualitative data collection; 3) To determine the configuration of factors responsible for STD transmission. We will collect demographic, behavioral, and psychosocial data across time (baseline, 5-6 months, and 12 months) so as to identify which factors contribute to high-risk sexual behavior. Particular attention will be given to patterns of interaction among independent variables. We will integrate these data with clinical and microbiological information (clinical symptomatology, STD test results, and virulence study results) collected at the same points in time in order to more fully understand STD transmission; 4) To evaluate intervention effectiveness over 2 follow-up periods, using study and control groups. Effectiveness will be assessed by changes in self-reported behavior and STD infection/reinfection; 5) To evaluate intervention effectiveness according to initial pregnancy and STD status; 6) As an exploratory sub-study (in conjunction with a Clinical Core study), to evaluate intervention effectiveness among women with a serious, STD-associated disease (Pelvic Inflammatory Disease) compared to that among women with an STD but no PID, and to that among disease-free participants; 7) As an exploratory sub-study, to evaluate the effectiveness of post- intervention support groups on achieving and sustaining behavior change. A prospective, stratified random design, using repeated measures will be employed. Based on """"""""worst-case"""""""" attrition estimates, we will recruit 2,440 (including the PID sub-sample) Mexican-American women at public prenatal, family-planning, and STD clinics (Clinical Core sites). Except for the PID sub-sample, half will be pregnant and 30% will have one or more STD. Linear and logistic regression will be the principal multivariate analysis techniques used.
| Shain, Rochelle N; Perdue, Sondra T; Piper, Jeanna M et al. (2002) Behaviors changed by intervention are associated with reduced STD recurrence: the importance of context in measurement. Sex Transm Dis 29:520-9 |
| Champion, J D; Piper, J; Shain, R N et al. (2001) Minority women with sexually transmitted diseases: sexual abuse and risk for pelvic inflammatory disease. Res Nurs Health 24:38-43 |
| Shain, R N; Piper, J M; Newton, E R et al. (1999) A randomized, controlled trial of a behavioral intervention to prevent sexually transmitted disease among minority women. N Engl J Med 340:93-100 |
| Newton, E R; Butler, M C; Shain, R N (1996) Sexual behavior and vaginal colonization by group B streptococcus among minority women. Obstet Gynecol 88:577-82 |
