A Pilot Study of a Combination STD Prevention Intervention for African-American Mothers and Their Adolescent Daughters

Background:  African-American women and adolescent girls are disproportionately burdened by STDs. To combat this health disparity, two CDC demonstrated effective behavioral STD/HIV prevention interventions have been developed for African-American women (SISTA) and adolescent African-American girls (HORIZONS), but these two separate interventions have never been implemented with African-American mother-adolescent daughter dyads.  Given high rates of single mother-headed households in African-American communities, providing STD/HIV prevention programming to both single mothers and daughters could reduce sexual risk-taking, but may also promote a supportive partnership between mother and daughter to engage in and sustain health-protective behaviors. 

Methods: Thirty-one single mother- adolescent daughter dyads completed baseline ACASI, were randomized to the dyadic intervention condition (mothers received SISTA, daughters received HORIZONS) or the daughter-only intervention condition (daughters received HORIZONS; mothers received no intervention); 84% completed a 3-month follow-up ACASI. ANOVAs assessed improvements in psychosocial mediators targeted in the intervention (e.g., partner communication, condom use self-efficacy) among mothers and daughters. ANCOVAs, adjusting for baseline values, assessed differential improvement in parent-adolescent sexual communication among dyads by condition.  

Results:  Among daughters, increases from baseline levels were found at follow-up for condom use self-efficacy skills (p = .003), STD/HIV risk appraisal (p = .03), and intentions to use condoms (p = .005). Among mothers, increases were found for condom use self-efficacy skills (p = .023), partner communication self-efficacy (p = .03) and STD/HIV risk appraisal (p = .08). Importantly, daughters in the dyadic intervention condition reported more frequent parent-adolescent communication about safe sex than those in the daughter-only condition (p = .10), and higher levels of comfort during these conversations compared to the daughter-only condition (p = .009).

Conclusions:  Simultaneously intervening with single African-American women and their adolescent daughters offers the potential to sustain positive outcomes for both mothers and daughters by reinforcing and supporting each other’s healthy behaviors.