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SiHLE was developed to address the STI/HIV/AIDS prevention needs of African-American
adolescent girls. Research has shown that this subgroup of the general population
is at higher risk than their White or Hispanic peers. SiHLE was originally
implemented in the South, where adolescent HIV prevalence was higher than any other
geographic region in the U.S.
Participants were girls seeking health services at community health agencies. Eliglible participants were African American between the ages of 14 and 18 who had engaged
in vaginal intercourse within the previous six months. At baseline, 522 girls, aged 14-18, completed the baseline survey and were randomized into either the
HIV-prevention intervention (n=251) or the general health control group (n=271).
The HIV-prevention intervention was grounded in social cognitive theory and the theory of gender and power. Participants explored issues related to ethnic and gender
pride, risk reduction strategies (including correct and consistent condom use), negotiating safer sex, and healthy relationships as they relate to practicing safer sex.
At the six-month follow-up, intervention girls reported using condoms more consistently in the previous 30 days than did their control group counterparts (intervention,
75.3% vs. control, 58.2%). At the 12-month follow-up, intervention girls reported more consistent condom use both in the previous 30 days (intervention, 73.3% vs.
control, 56.5%) and during the entire 12-month review period (adjusted odds ratio, 2.30; 95% CI, 1.51-3.5; P<.001). In general, at the 12-month point, intervention girls
were more likely to have used a condom at last intercourse, and less likely to have had a new sexual partner in the last 30 days. They also had better condom application
skills and a higher percentage of condom-protected sex acts than their control-group peers. Promising effects were also observed for chlamydia infections and
self-reported pregnancy.
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