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Package Components:

35 page Facilitator Manual Behavioral Skills Training Pamphlet (25 qty) 4 Posters; and 1 Handout 2 Videos on DVD: “Let’s Try Something New,” (negotiation) and “He Said He Loved Me” (vulnerability)
Basic Package	$145	Order
DVD only	$89	Order

AUTHORS

Loretta Sweet Jemmott Ph.D., R.N., F.A.A.N. and John Jemmott III, Ph.D.

OVERVIEW OF THE CURRICULUM

The overall purpose of the Sister-To-Sister HIV Risk Reduction Intervention Project one-on-one 20-minute skill and safer sex Intervention is to provide women with the knowledge, beliefs, motivation, and confidence necessary to help them change their behavior in ways that will reduce their risk for STIs, especially HIV. It is also designed to build self-efficacy and skills to practice these behaviors.

GOAL OF THE CURRICULUM

The goal of Sister to Sister is to increase participants’ knowledge and vulnerability regarding the impact of engaging in risky sexual behavior and to provide information to reduce those risks. Additional goals are to increase participants’ confidence and skills in negotiating condom use and to insure that condoms are used correctly and consistently.

Specifically, this curriculum emphasizes that participants can reduce their risk for STDs by engaging in safer sex behaviors.

CURRICULUM OBJECTIVES

Women who participate in the program will be able to:

1. Identify the correct information regarding the transmission, etiology and prevention of HIV;
2. Identify their feelings about how to integrate STI prevention in the context of their lives;
3. Identify and demonstrate the correct steps to using a condom and show the steps on an anatomically correct penis model;
4. Describe ways that condoms can be made to be a pleasurable part of the sexual experience irrespective of serostatus;
5. Negotiate with a partner about using condoms and or abstaining from sex in a role play situation;
6. Demonstrate a stronger sense of pride, responsibility and intentions in practicing safer sex strategies
   • Women in the skill building interventions compared to the information intervention or health-control intervention participants. reported:
   • (1) a greater proportion of condom use,
   • (2) a greater proportion of using a condom the last time they had intercourse
   • (3) less unprotected sexual intercourse
   • These results were statistically significant at the 3 month follow up and 12 month follow up. None of the contrasts was statistically significant at 6-month follow-up.
   • Women in the skill-building interventions were less likely to test positive for a STD at the 12 month follow up than were those in the control group.
   • Condom use demonstration by the provider using anatomically correct penis models followed by the client demonstrating and practicing the skill
   • Emphasizing that condom use can prevent HIV/STIs.
   • Teaching and practicing strategies to make condoms fun and pleasurable
   • Demonstrating and practicing negotiation and refusal skills through role play using the 4-step SWAT Negotiation Strategy and the Reframing Technique of their partner’s reaction
   • The use of the theme “Sister-to-Sister! Respect Yourself! Protect Yourself! Because You Are Worth It!” throughout the curriculum as a strategy to empower the women and build self-efficacy
   • Demonstrating a caring attitude by statements such as, “I truly care about you, I believe in you and you can do this”. Showing this feeling throughout the intervention via active listening, eye contact, supportive feedback, being non-judgmental, showing respect, etc.
   • Use of the Facilitator Teaching Guide and the Participant Guide to initiate discussion.
   • Use of  video clips specifically selected for the intervention

CONTENT OUTLINE

Activity A:  Introduction and Overview

Activity Goals and Objectives: To provide the woman with a general overview and foster excitement and enthusiasm about their participation.

Activity B: Video Clips

Activity Goals and Objectives: To reinforce information on Women and AIDS and to increase perceived risk of HIV infection.

Activity C: The Risk Assessment Inventory

Activity Goals and Objectives: To assess their personal risk of HIV infection.

Activity D: Teach content using Teaching guide

Activity Goals and Objectives: To teach and reinforce information on HIV/AIDS.

Activity E: Condom Information and Condom Use

Activity Goals and Objectives: To build self-efficacy and skills by teaching and reinforcing information on the correct ways to use a condom and how to make them fun and pleasurable.

Activity F: Negotiation Skills and video Clip

Activity Goals and Objectives: To build self-efficacy through teaching negotiation strategies and skills for talking to their partner about using condoms.

Activity G:  Role Play

Activity Goals and Objectives: To build self-efficacy and skills by helping women practice discussing condom use with a partner.

Activity H: HIV and Injection Drug Use

Activity Goals and Objectives: To provide correct information about HIV and injection drug use to enhance and reinforce participants’ knowledge.

Activity I: Closing

Activity Goals and Objectives: To build self-efficacy to engage in safer sex behaviors.

SPECIAL CONSIDERATIONS

The curriculum requires the use of equipment that can play a DVD.

TYPES OF ACTIVITIES

The Sister To Sister curriculum involves a review of the Sister-to-Sister Participant Behavioral Skills Training Pamphlet, 2 videos, “He Said He Loved Me” and “Lets Try Something New”, condom demonstration, practice with an anatomical correct penis model, and role-playing.  Curriculum activities are also designed to help women recognize that faulty reasoning and decision-making can increase their risk of HIV infection.  The activities help understand the adverse consequences of participating in unsafe sexual activity and the positive consequences of safer sexual practices, including abstinence.

The women engage in activities to increase comfort with condom use and to allay common concerns about the negative effects of condom use on sexual enjoyment and spontaneity.  Participants handle condoms and learn to use condoms correctly.  Two brief video clips evoke feelings, thoughts, attitudes, and beliefs about HIV infection, AIDS, and sexual risk behavior while highlighting prevention skills.

The women also participate in role-playing scenarios that allow them to observe, analyze, and practice the skills of negotiating abstinence or condom use in a variety of circumstances.

THEORETICAL FRAMEWORK

Research shows that curriculum are more effective when based on sound theoretical frameworks. The Sister-to-Sister HIV Risk Reduction Intervention Project draws upon the Social Cognitive Theory (Bandura, 1982, 1986, 1989) Three theoretical components of the social cognitive theory, perceived self-efficacy, outcome expectancies, and modeling have utility in the reduction of HIV transmission related sexual behaviors. Self efficacy is a participant’s belief that they have the confidence to engage in behavior proposed (ex. using condoms). Outcome expectancy is the belief that the outcome of the behavior the participant is trained to engage in will be positive. Modeling is acquiring skills needed to implement the behavior the participant is trained to engage in.

Effects on Sexual Behaviors

Effects on STI Rates

Core Elements

Implementation by specially trained female health care staff that provides direct service to women.

RECOMMENDED INTERVENTION TRAINING

Clinic staff administering the intervention must have completed a six-hour Sister-To-Sister HIV Risk Reduction Intervention training session. For more intervention about training options for Sister to Sister click here or go to the Courses section and look up Trainings.

INTERVENTION

In the research study we tested the efficacy of brief HIV/sexually transmitted disease (STD)
risk-reduction interventions for African-American women in primary care settings.

RESEARCH DESIGN

In a randomized controlled trial, 564 African-American women recruited at a Newark, NJ, inner-city women’s health clinic were assigned to a 20-minute one-on-one HIV/STD behavioral skill-building intervention, 200-minute group HIV/STD behavioral skill-building intervention, 20-minute one-on-one HIV/STD information intervention, 200-minute group HIV/STD information intervention, or 200-minute health intervention control group. Primary outcomes were self-reported sexual behaviors in the previous 3 months; secondary outcome was STD incidence.

The one-on-one 20-minute model consists of a risk assessment interview guide, 4 educational posters, a HIV/STI prevention behavioral skills training pamphlet, 2 short, dramatic video role-play clips scripted and professionally acted.

BEHAVIORAL FINDINGS

At 12-month follow-up, participants in the skill-building interventions:

• Reported less unprotected sexual intercourse than did participants in the information interventions (Cohen’s d ld] = 0.23. P=.O2),
• Reported a greater proportion of protected sexual intercourse than did information intervention participants (c/=0.21, P=.O5) and control participants (d=0.24, P=.03),
• Were less likely to test positive for an STD than were control participants {d=0.2Q, P=.O3).

CONCLUSIONS

This study suggests that brief single-session, one-on-one or group skill-building interventions may reduce HIV/STD risk behaviors and STD morbidity among inner-city African-American women in primary care settings. (American Journal of Public Health 2007;97:1034-1040. doi:10.2105/AJPH.2003.020271)*

THEORETICAL FRAMEWORK

The Sister-to-Sister HIV Risk Reduction Intervention Project draws upon the Social Cognitive Theory (Bandura, 1982, 1986, 1989) Three theoretical components of the social cognitive theory, perceived self-efficacy, outcome expectancies, and modeling have utility in the reduction of HIV transmission related sexual behaviors. Self-efficacy is a participant’s belief that they have the confidence to engage in behavior proposed (ex. using condoms). Outcome expectancy is the belief that the outcome of the behavior the participant is trained to engage in will be positive. Modeling is acquiring skills needed to implement the behavior the participant is trained to engage in.

*For copies of the original research please contact Select Media, Inc. at 800-707-6334 or
research@selectmedia.org.

Target Audience

African- American, Hispanic and White adult women.

Curriculum Video Samples

Let’s Try Something New

He Told Me He Loved Me

Target Audience

African-American, Hispanic and White adolescents, ages 11-13 who attend middle schools and youth-serving community based programs.