| FOCUS |
SUMMARY
SAFER SEX INTERVENTION (SSI) is an individualized STI intervention program aimed at sexually active young women, ages 13-23, diagnosed with an STI. The overall goals are to reduce high-risk sexual behaviors, increase condom use and prevent the recurrence of STIs among sexually active young women. SSI was designed for delivery at the time of STI diagnosis/treatment, when the participant was most likely to be contemplating her diagnosis relative to her sexual risk behaviors. The intervention is administered one-on-one and face-to-face using one of two discrete 30- to 50-minute sessions. The health educator determines which version to use with each participant based on the participant's self-identified stage of behavior change using the Wheel of Change exercise.
SSI was evaluated in randomized control trial in a clinical setting. At baseline, less than half of the participants reported condom use during their last sexual encounter. More than a third (36%) had been pregnant sometime in the past and 18% were mothers.
At 1-month follow up, the intervention condition subjects had significantly increased sexual risk knowledge compared to control group subjects (P=.02) and exhibited a greater increase in positive attitudes towards condom use compared to control group subjects (P=.007). At 6-month follow up, intervention subjects reported fewer instances of sexual intercourse with non-main partners than in the control condition (P=.01). In other words, they were more likely to report lower sexual risk (sex with a non-main partner) as compared to the standard-of-care (control) condition. At the 6-month follow-up, (consistent with findings at the 1-month follow-up) the intervention condition had a greater increase in positive attitudes regarding condoms (P=.007) compared to the control group. The intervention group also showed steady positive progression along the Wheel of Change stages at each follow up. By the conclusion of the evaluation (at 12-months follow up), most participants who completed the exercise indicated that they were in the Action (38%) or Maintenance (25%) stage (P=.04).
Although results with P>.05 are not statistically significant and must be interpreted with caution, these findings suggest that an individualized safer sex intervention can work to change attitudes and behaviors about condom use, reduce the numbers of sexual partners that an STI-infected adolescent girl may have, and suggest secondary abstinence as an option.
SUITABLE FOR
USE IN
SSI is appropriate for use in clinics and may be appropriate in community based organizations providing sexual health services to young women. The intervention is led by a female health educator.
ORIGINAL INTERVENTION
SAMPLE
Age, Gender
The original intervention sample consisted of 123 adolescent girls with a mean age of 17.2 (range 13.9-22.0)
Race/Ethnicity
The sample self-identified as non-Hispanic black (49%), Hispanic (18%), White (14%), and Other (17%)
PROGRAM LENGTH
SSI is delivered in an intensive single session, customized to the participant, lasting 30-50 minutes. In the original implementation, there were follow-up booster sessions at one, three, six, and twelve months following enrollment.
STAFFING REQUIREMENTS/TRAINING
In the original implementation, SSI was conducted by a female health educator on a one-to-one basis. The health educators received training in the theoretical underpinnings of the intervention, and in motivational interviewing techniques.
Although all PASHA boxes have been designed to minimize the effort of implementation at each individual adopter site, some may want more formalized training. The original developer is available for consultancy. Please contact Dr. Lydia Shrier directly via email (lydia.shrier@childrens.harvard.edu) for additional information.
In the event that the original developer is unable to provide training for their program, Sociometrics has trainers on staff who can conduct training for any archive program. To discuss your training needs, please contact PASHA staff at Sociometrics (650)949-3282 between 8 a.m. and 5 p.m. Pacific Time.
|
Primary
Pregnancy Prevention
School-Based