Efficacy of SISTA South Africa on sexual behavior and relationship control among isiXhosa women in South Africa: Results of a randomized-controlled trial

Gina M. Wingood, Priscilla Reddy, Delia L. Lang, Dorina Saleh-Onoya, Nikia Braxton, Sibusiso Sifunda, Ralph DiClemente

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
Volume63
Issue numberSUPPL. 1
DOIs
StatePublished - Jun 1 2013

Fingerprint

Behavior Control
South Africa
Sexual Behavior
Randomized Controlled Trials
HIV
Odds Ratio
Confidence Intervals
Health Educators
Sexual Partners
Vulnerable Populations
Sexually Transmitted Diseases
Risk-Taking
African Americans
Curriculum
Incidence
Health

Keywords

  • Dry Sex
  • HIV intervention
  • HIV stigma
  • IsiXhosa-speaking women
  • Randomized controlled trial
  • Relationship control
  • South Africa

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Efficacy of SISTA South Africa on sexual behavior and relationship control among isiXhosa women in South Africa : Results of a randomized-controlled trial. / Wingood, Gina M.; Reddy, Priscilla; Lang, Delia L.; Saleh-Onoya, Dorina; Braxton, Nikia; Sifunda, Sibusiso; DiClemente, Ralph.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 63, No. SUPPL. 1, 01.06.2013.

Research output: Contribution to journalArticle

Wingood, Gina M. ; Reddy, Priscilla ; Lang, Delia L. ; Saleh-Onoya, Dorina ; Braxton, Nikia ; Sifunda, Sibusiso ; DiClemente, Ralph. / Efficacy of SISTA South Africa on sexual behavior and relationship control among isiXhosa women in South Africa : Results of a randomized-controlled trial. In: Journal of Acquired Immune Deficiency Syndromes. 2013 ; Vol. 63, No. SUPPL. 1.
@article{25842d2482cc4405b8975ee9fe47bf77,
title = "Efficacy of SISTA South Africa on sexual behavior and relationship control among isiXhosa women in South Africa: Results of a randomized-controlled trial",
abstract = "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.",
keywords = "Dry Sex, HIV intervention, HIV stigma, IsiXhosa-speaking women, Randomized controlled trial, Relationship control, South Africa",
author = "Wingood, {Gina M.} and Priscilla Reddy and Lang, {Delia L.} and Dorina Saleh-Onoya and Nikia Braxton and Sibusiso Sifunda and Ralph DiClemente",
year = "2013",
month = "6",
day = "1",
doi = "10.1097/QAI.0b013e31829202c4",
language = "English (US)",
volume = "63",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "SUPPL. 1",

}

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

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

UR - http://www.scopus.com/inward/record.url?scp=84880204579&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880204579&partnerID=8YFLogxK

U2 - 10.1097/QAI.0b013e31829202c4

DO - 10.1097/QAI.0b013e31829202c4

M3 - Article

VL - 63

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - SUPPL. 1

ER -