TY - JOUR
T1 - Efficacy of SISTA South Africa on sexual behavior and relationship control among isiXhosa women in South Africa
T2 - Results of a randomized-controlled trial
AU - Wingood, Gina M.
AU - Reddy, Priscilla
AU - Lang, Delia L.
AU - Saleh-Onoya, Dorina
AU - Braxton, Nikia
AU - Sifunda, Sibusiso
AU - DiClemente, Ralph J.
PY - 2013/6/1
Y1 - 2013/6/1
N2 - Background: The HIV epidemic has a devastating impact among South African women. The current study evaluated the efficacy of SISTA South Africa, a culturally congruent HIV intervention for isiXhosa women in South Africa, which was adapted from SISTA, an HIV intervention for African American women. Methods: A randomized-controlled trial recruited 342 isiXhosa women aged 18-35 years. Participants were randomized to the general health comparison or the SISTA South Africa intervention. Xhosa-speaking peer health educators tailored the SISTA South Africa curriculum, while maintaining the core elements of the original SISTA intervention. Participants completed assessments at baseline and 6 months follow-up. Results: Relative to participants in the comparison, participants in the HIV intervention reduced the frequency of unprotected vaginal intercourse acts (adjusted mean difference = 1.06; P = 0.02), were more likely to report not desiring dry sex (adjusted odds ratio = 0.229; 95% confidence interval = 0.10 to 0.47; P = 0.0001), and were more likely to perceive that their main sexual partner did not desire dry sex (adjusted odds ratio = 0.24; 95% confidence interval = 0.11 to 0.52; P = 0.0001). In addition, women randomized to the intervention also reported an increase in HIV knowledge, greater relationship control, and had more opposing attitudes toward HIV stigma. The HIV intervention did not reduce sexually transmitted infection incidence. Conclusions: This trial demonstrates that an HIV intervention, which is adapted to enhance its gender and cultural relevance for rural isiXhosa women, can reduce self-reported sexual risk behaviors and enhance mediators of HIV among this vulnerable population.
AB - Background: The HIV epidemic has a devastating impact among South African women. The current study evaluated the efficacy of SISTA South Africa, a culturally congruent HIV intervention for isiXhosa women in South Africa, which was adapted from SISTA, an HIV intervention for African American women. Methods: A randomized-controlled trial recruited 342 isiXhosa women aged 18-35 years. Participants were randomized to the general health comparison or the SISTA South Africa intervention. Xhosa-speaking peer health educators tailored the SISTA South Africa curriculum, while maintaining the core elements of the original SISTA intervention. Participants completed assessments at baseline and 6 months follow-up. Results: Relative to participants in the comparison, participants in the HIV intervention reduced the frequency of unprotected vaginal intercourse acts (adjusted mean difference = 1.06; P = 0.02), were more likely to report not desiring dry sex (adjusted odds ratio = 0.229; 95% confidence interval = 0.10 to 0.47; P = 0.0001), and were more likely to perceive that their main sexual partner did not desire dry sex (adjusted odds ratio = 0.24; 95% confidence interval = 0.11 to 0.52; P = 0.0001). In addition, women randomized to the intervention also reported an increase in HIV knowledge, greater relationship control, and had more opposing attitudes toward HIV stigma. The HIV intervention did not reduce sexually transmitted infection incidence. Conclusions: This trial demonstrates that an HIV intervention, which is adapted to enhance its gender and cultural relevance for rural isiXhosa women, can reduce self-reported sexual risk behaviors and enhance mediators of HIV among this vulnerable population.
KW - Dry Sex
KW - HIV intervention
KW - HIV stigma
KW - IsiXhosa-speaking women
KW - Randomized controlled trial
KW - Relationship control
KW - South Africa
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U2 - 10.1097/QAI.0b013e31829202c4
DO - 10.1097/QAI.0b013e31829202c4
M3 - Article
C2 - 23673889
AN - SCOPUS:84880204579
VL - 63
SP - S59-S65
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
SN - 1525-4135
IS - SUPPL. 1
ER -