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Sisters Saving Sisters

Overview of the Curriculum

Sisters Saving Sisters is a five-module skills-based risk-reduction intervention administered in small groups of 2–10 female adolescents by trained facilitators in one 4.5 hour session in a community-based clinic setting. While the curriculum was designed to be used with smaller groups, it can be implemented with larger numbers as well if more time is built into each session. It is appropriate for various community settings, including schools, and youth agencies. The program engages participants in activities such as role-playing, handling, and practicing correct placement of condoms using anatomical models; teaches effective condom negotiation skills; and discusses the barriers to condom use such as alcohol and drug use.

Sisters Saving Sisters aims to address the higher risk of HIV/STDs in Latina and African American female adolescent populations. The program is designed to reduce frequency of unprotected sexual intercourse (with and without drug and alcohol use), number of sexual partners, and incidence of sexually transmitted infections. This curriculum is designed to empower the young women to change their behavior in ways that will reduce their risk of becoming infected with HIV, other STDs, and significantly decrease their chances of being involved in unintended pregnancies.

While the curriculum acknowledges that abstinence is the most effective way to eliminate these risks, it also acknowledges that abstinence is not the path that many young people will choose. Therefore, the curriculum spends a great deal of time encouraging the practice of safer sex and condom use. It also addresses the underlying attitudes and beliefs that many young women have about condoms, provides information and exercises that teach them how to use condoms correctly, and give them the confidence they need to choose and negotiate safer-sex practices.

Curriculum Objectives

At the completion of the Sister Saving Sisters curriculum, young women will have:

  • Increased knowledge about prevention of HIV, STDs, and pregnancy
  • More positive attitudes/beliefs about condom use
  • Increased confidence in their ability to negotiate safer sex and to use condoms correctly
  • Increased negotiation skills
  • Improved condom skills
  • Stronger intentions to use condoms if they have sex
  • A lower incidence of HIV/STD risk-associated sexual behavior
  • A stronger sense of pride and responsibility in making a difference in their lives.

Curriculum Sessions

Sisters Saving Sisters has four major components:

  • The first component focuses on goals and dreams and their relationship to adolescent sexual behavior.
  • The second component emphasizes knowledge, including the causes, transmission, and prevention of HIV, STDs, and teenage pregnancy.
  • The third component focuses on beliefs and attitudes about condoms, HIV, STDs, and pregnancy.
  • The fourth stresses skills and self-efficacy including negotiation, refusal, and condom use skills. It also provides time for practice, reinforcement, and support.

The Modules

  • Module 1: Introduction and Overview
  • Module 2: Understanding Personal Vulnerability
  • Module 3: Developing Condom Use Skills
  • Module 4: Improving Sexual Choices and Negotiation Skills
  • Module 5: Role-Play, AIDS Basketball, and Review

Unique Features of the Curriculum

Sisters Saving Sisters includes a series of fun and interactive learning experiences designed to increase participation and help young teenage women understand the kind of faulty reasoning and decision-making that can lead to HIV, STDs, and pregnancy. The activities include viewing culturally and gender sensitive video clips. Each activity is brief, and most are active exercises that require the participants to get up out of their chairs and interact with one another. This maintains their interest and attention in a way that lectures or lengthy group discussions do not.

Theoretical Framework

Sisters Saving Sisters draws upon three theories: the Social Cognitive Theory, the Theory of Reasoned Action, and the Theory of Planned Behavior. There are two major concepts included in these theories: 1) self-efficacy or perceived behavioral control beliefs, which are defined as a person's confidence in his or her ability to take part in the behavior, i.e. use a condom; and 2) outcome expectancies or behavioral beliefs, which are beliefs about the consequences of the behavior. Sisters Saving Sisters addresses each of the principles, usually in more than one activity.

Ordering and Training Information

Ordering: Contact ETR to order materials: www.etr.org/ebi/programs/sisters-saving-sisters.

Training: The program uses facilitators with a bachelor's degree and experience working with inner city adolescents. Facilitators also receive an eight-hour training prior to the implementation of the program.

Evaluation Fact Sheet

Intervention

Sisters Saving Sisters addresses the higher risk of HIV/STDs in Latina and African American female adolescent populations. The program is designed to reduce frequency of unprotected sexual intercourse (with and without drug and alcohol use), number of sexual partners, and incidence of sexually transmitted infections. This curriculum is designed to empower the young women to change their behavior in ways that will reduce their risk of becoming infected with HIV, other STDs, and significantly decrease their chances of being involved in unintended pregnancies.

Behavioral Findings

At the 12-month follow-up, adolescents participating in the intervention reported: significantly fewer days of sex without condom use in the previous three months; significantly fewer sexual partners in the previous three months; and significantly fewer days of unprotected sex while high on drugs or alcohol. They were also significantly less likely to report having had multiple sex partners in the previous three months and to test positive for gonorrhea, chlamydia, or trichomonas.

Research Design

Study participants were sexually experienced predominantly African American and Latino girls who were patients at a family planning clinic (an adolescent medicine clinic at a children’s hospital serving a low-income, inner city community in Philadelphia, Pennsylvania.) Their age range was 12 to 19 years (mean age 15.5 years.) The baseline study sample of 682 adolescent clinic patients is characterized by the following:

  • 68% African American, 32% Latina
  • 100% Female
  • 99% heterosexual, less than 1% homosexual/bisexual

References

Jemmott, J. B., Jemmott, L. S., Braverman, P. K., & Fong, G. T. (2005). HIV/STD Risk Reduction Interventions for African American and Latino Adolescent Girls at an Adolescent Medicine Clinic: A Randomized Controlled Trial. Archives of Pediatrics & Adolescent Medicine, 159, (5) 440–449.