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Horizons: STI/HIV Sexual Risk Reduction Intervention for African American Girls

Overview of the Curriculum

Horizons is a culturally tailored STD/HIV intervention for African American adolescent females seeking sexual health services. The intervention was developed to address a range of risk factors, including personal, relational, socio-cultural, and structural factors. It aims to reduce STDs by improving STD/HIV risk-reduction knowledge and condom use skills, facilitating communication with male partners about safer sex practices and STDs, facilitating male sex partners' access to STD screening and treatment, and reducing female adolescents' frequency of douching.

Curriculum Objectives

The overall goals of the intervention are to reduce recurrent STIs and enhance STI/HIV preventive behaviors.

Curriculum Sessions

Horizons is an interactive two-session STI-prevention intervention. The main component of this intervention includes two group sessions (4 hours each), implemented in small groups on two consecutive Saturdays. The sessions are intended to foster a sense of cultural and gender pride and emphasize the diverse individual and social factors contributing to adolescents' STD/HIV risk.

Unique Features of the Curriculum

Horizons participants receive $20 vouchers redeemable by participants' male partner(s) toward the cost of STD/STI services.

They also receive a total of four (15-minute) follow-up telephone contacts, one every other month, to reinforce prevention information presented in group sessions.

Ordering and Training Information

Ordering: Program materials are available by contacting Ralph DiClemente, Ph.D., Emory University Rollins School of Public Health at rdiclem@emory.edu or you may order program materials through Sociometrics Corporation:
Program Archive on Sexuality, Health, and Adolescence (PASHA)
Sociometrics Corporation
170 State Street, Suite 260
Los Altos, CA 94022-2812
Tel. (650) 949-3282
Fax (650) 949-3299
Email: socio@socio.com

The Program Archive on Sexuality, Health, and Adolescence (PASHA), funded by the National Institute of Child Health and Human Development and the Office of Adolescent Health in the Department of Health and Human Services, is a collection of effective program replication kits designed to reduce teen pregnancy and STI/HIV/AIDS in adolescents.

Training: Consult Sociometrics or Ralph DiClemente about training options.

Evaluation Fact Sheet

Intervention

Horizons is a culturally tailored STD/HIV intervention for African American adolescent females seeking sexual health services. The intervention was developed to address a range of risk factors, including personal, relational, socio-cultural, and structural factors. It aims to reduce STDs by improving STD/HIV risk-reduction knowledge and condom use skills, facilitating communication with male partners about safer sex practices and STDs, facilitating male sex partners' access to STD screening and treatment, and reducing female adolescents' frequency of douching.

Behavioral Findings

When the program participants were compared to their control group peers, the program participants had, on average, a 35% lower risk of having Chlamydia than the control participants (RR, 0.65; 95% CI, 0.42 to 0.98; P=.04). Overall, participants in the program condition had higher self-reported condom use during sexual activity in the previous 14 days (P=.004) and 60 days (P<.001) when compared to the control condition. Program participants were more likely to report consistent condom use for 14 days, 60 days, and at their last sexual activity (P=.04, P=.01, P=.005, respectively). The program condition also reported reduced douching as compared to the control condition (P=.001).

Based on an average of the 6- and 12-month follow-ups: youth participating in the intervention were significantly less likely to test positive for Chlamydia and were significantly more likely to report both consistent condom use and using a condom at last sex.

Research Design

Horizons was evaluated with a randomized control trial that included two conditions (control and intervention). Data was collected from the subjects at baseline, 6-months and 12-months post-completion of the program.

The target population was African American adolescent females seeking sexual health services. Participants were between the ages of 15 and 21 and were looking to access services from a reproductive health clinic as they had reported engaging in vaginal intercourse in the past 60 days. They were single and were not pregnant or attempting to get pregnant at the time of recruitment. Their average age was 17.8 years. The setting was three clinics in downtown Atlanta, Georgia, providing sexual health services to predominantly inner-city adolescents.

References

DiClemente, R. J., Wingood, G. M., Rose, E. S., Sales, J. M., Lang, D. L., Caliendo, A. M., Hardin, J. W., & Crosby, R. A. (2009). Efficacy of sexually transmitted disease/human immunodeficiency virus sexual risk-reduction intervention for African American adolescent females seeking sexual health services. Archives of Pediatric & Adolescent Medicine, 163(12), 1112–1121.