Efficacy of an HIV prevention intervention for Latinas: A randomized controlled trial

Background: Latinas are disproportionately impacted by the HIV epidemic; being nearly 4 times as likely to acquire HIV/AIDS as white women in the US. Yet, Latinas remain an underserved population. Few interventions have demonstrated efficacy in decreasing HIV-associated risk behaviors among adult Latinas, and available interventions do not address the diversity of Latinas. This study describes the efficacy of AMIGAS, a culturally appropriate adaptation of SiSTA, a widely disseminated HIV intervention initially developed for African-American women. Methods: A randomized controlled trial recruited 252 Latinas 18–35 years of age. Participants were randomized to the 4-session AMIGAS intervention or 1-session general health comparison. Participants completed ACASI assessments at baseline and at 3- and 6-month follow-up. Logistic and linear GEE regression models were used to assess intervention efficacy. Results: Over the entire 6-month follow-up, AMIGAS participants reported more consistent condom use during the past 90 (AOR=4.81; p=.00001) and 30 days (AOR=3.14; p=.0001) and at last sex (AOR=2.76; p=.0001), and a higher mean percent condom use during the past 90 (relative change = 55.7%; p=.00001) and 30 days (relative change = 43.8%; p=.0007) prior to assessments than comparison participants. AMIGAS participants also reported fewer traditional views of gender roles (p=.008), greater self-efficacy for negotiating safer sex (p=.00001) and using condoms (p=.00001), greater feelings of power in relationships (p=.02), greater HIV knowledge (p=.009), and perceived fewer barriers to using condoms (p=.00001). Conclusions: This is the first HIV prevention trial to demonstrate efficacy of an intervention adapted linguistically and culturally for ethnically diverse, predominantly foreign-born Latinas.