Adapting an HIV Prevention Evidence Based Intervention for Non-English speaking monolingual women: Lessons from the Chieh Mei Ching Yi/Sisterhood Project

Monolingual API women in LA County face severe obstacles to information and capacity for HIV prevention, including immigration status, poverty, exploitation in employment, low human capital (education, job skills), and linguistic isolation. To address these obstacles, APAIT designed and is currently implementing the Sisterhood Project. An adaptation of SISTA, a CDC DEBI, the Sisterhood Project targets monolingual Chinese women who are involved in sex work through employment at massage parlors in LA County.

Adaptation required substantial changes to SISTA to address barriers these monolingual Chinese women face such as scheduling constraints and a culturally distinct way of understanding empowerment and self-esteem. This resulted in fewer but longer sessions, changes to the curriculum to accommodate Chinese norms of self-esteem and gender, and varied program incentives.

For the purpose of evaluation, pre, post and follow-up surveys were collected to assess HIV transmission knowledge and risk behaviors. Our pilot phase data, including pre-/post-/1 month follow up, show that there is an increase in HIV knowledge and intention to engage in risk reduction behaviors among participants. By Feb 2009, we aim to collect and analyze pre-, post- and follow-up survey data on 50 women.

Non-English speaking monolingual communities face a wide rage range of health disparities that inhibit them from accessing HIV/AIDS and other services. It is crucial that organizations address the social and cultural needs of marginalized communities. In order to address the needs, adapting evidence-based interventions requires understanding of cultural norms and ability to adjust to structural and individual barriers.