BACKGROUND: The objective of this study was to evaluate a culturally adapted evidence-based intervention (EBI) called EMPWR for impacts on sexually transmitted infection (STI) screening and sexual health risk behaviors. METHODS: We enrolled Native American adults with recent binge substance use from a rural, reservation community in the Southwest into a 1:1 randomized controlled trial (RCT) conducted July 2015 to June 2019. All participants were offered non clinic-based self-administered STI screening. Data were collected via self-report at baseline, 3-months and 6-months post-intervention. Baseline and endline data are presented. RESULTS:301 participants enrolled and had mean age of 33.8 years; 46.5% of the sample were female, and 9.1% were employed at baseline. EMPWR participants were more likely to complete STI self-screening than control participants (38.2% vs. 23.8%, p=0.0275). EMPWR participants reported fewer unprotected sex acts in the past 3 months (9.3 vs. 16.0, p= 0.001) and were more likely refuse sex if their partner wasn't tested (23.6% vs. 12.4%, p= 0.049). The between group difference in STI positivity one year after study completion was nearing statistical significance (intervention=39.5% vs. control=59.6%, p=0.0575). CONCLUSIONS: The culturally adapted EBI, EMPWR, increased uptake of STI screening and refusal of sex if partner was not STI tested and decreased the frequency of unprotected sex acts among Native American adults with recent binge substance use living on a rural reservation. Future research is needed to examine EMPWR impacts among other Native American subgroups, and its potential for advancing sexual health equity in this high priority population.
RCT Entities:
BACKGROUND: The objective of this study was to evaluate a culturally adapted evidence-based intervention (EBI) called EMPWR for impacts on sexually transmitted infection (STI) screening and sexual health risk behaviors. METHODS: We enrolled Native American adults with recent binge substance use from a rural, reservation community in the Southwest into a 1:1 randomized controlled trial (RCT) conducted July 2015 to June 2019. All participants were offered non clinic-based self-administered STI screening. Data were collected via self-report at baseline, 3-months and 6-months post-intervention. Baseline and endline data are presented. RESULTS: 301 participants enrolled and had mean age of 33.8 years; 46.5% of the sample were female, and 9.1% were employed at baseline. EMPWR participants were more likely to complete STI self-screening than control participants (38.2% vs. 23.8%, p=0.0275). EMPWR participants reported fewer unprotected sex acts in the past 3 months (9.3 vs. 16.0, p= 0.001) and were more likely refuse sex if their partner wasn't tested (23.6% vs. 12.4%, p= 0.049). The between group difference in STI positivity one year after study completion was nearing statistical significance (intervention=39.5% vs. control=59.6%, p=0.0575). CONCLUSIONS: The culturally adapted EBI, EMPWR, increased uptake of STI screening and refusal of sex if partner was not STI tested and decreased the frequency of unprotected sex acts among Native American adults with recent binge substance use living on a rural reservation. Future research is needed to examine EMPWR impacts among other Native American subgroups, and its potential for advancing sexual health equity in this high priority population.
Authors: Christopher G Kemp; Rachel Chambers; Francene Larzelere; Angelita Lee; Laura C Pinal; Anna M Slimp; Lauren Tingey Journal: Int J Environ Res Public Health Date: 2022-04-03 Impact factor: 3.390