Efficacy of an HIV/STI sexual risk-reduction intervention in reducing incident high-risk HPV and non-viral STIs among African-American women: Results of a randomized controlled trial

BACKGROUND: African-American women particularly those in the Deep South experience a disproportionate burden of HIV/STIs. To address this health disparity, we evaluated the efficacy of an intervention in reducing non-viral STIs and HPV, and risky sexual behaviors among African-American women in a Deep South state. METHODS: A random sample of African-American women, 18-29 years of age (N = 848), recruited from Kaiser Permanente in Atlanta, Georgia, participated in a trial of a gender and relationship-focused HIV/STI sexual risk-reduction intervention. RESULTS: Over the 12-months follow-up, participants in the HIV/STI intervention, relative to the general health condition, were less likely to have non-viral incident STIs (OR, 0.62; 95% CI, 0.40-0.96; P =.033), an incident infection of high-risk HPV (OR, .37; 95% CI, 0.18-0.77; P = .008), and were less likely to have either a non-viral STI or HPV (OR, .35; 95% CI, .17-.70; P=.003). Additionally, participants in the intervention, were less likely to have multiple male sexual partners, were more likely to use condoms during oral sex, inform their main sex partner of their STI test results, ask their main sex partner to have an STI test, report that their main sex partner was treated for STIs, and to report not douching. CONCLUSION: The magnitude and scope of effects strengthen confidence in the efficacy of the intervention to reduce incident HPV and non-viral STIs and enhance preventive behaviors and mediators of safer sex. Efficacious sexual risk-reduction interventions, addressing issues of race and gender, remain valuable tools to reduce women's risk of disease.