XVII International AIDS Conference SISTERACT An Intergenerational HIV Prevention Program XVII International AIDS Conference Mexico City, Mexico, August 4, 2008 The Women’s Collective, Washington, DC Funded by the Office on Women’s Health, U.S.A

The Women’s Collective Founded in 1993 by Patricia Nalls. Provides group and individual support through HIV Care Management and Prevention services. Contributes to local, national and international advocacy on women’s health and HIV issues.

Girls, Women & HIV/AIDS in Washington, D.C 1 in 20 DC residents is living with HIV and 1 in 50 has AIDS The number of women living with AIDS in DC has increased more than 76% over the last six years African American women account for 90% of newly reported HIV/AIDS cases in Washington, DC while making up 58% of the population The most common mode of HIV transmission among women is heterosexual contact (61%).

A Look At Female High School Students in Washington, DC 51.2% have ever had sexual intercourse 5.3% have had sexual intercourse before the age of 13 14.3% have had sexual intercourse with four or more partners during their life 3.0% have injected illegal drugs *DC Youth Risk Behavior Survey 2007 Students grades 9-12, 84% of DC respondents were black

What is SISTERACT? Intergenerational HIV prevention pilot program for African American girls & women ages 12 to 80+ A space for strengthening culturally and age appropriate communication about sexual health and HIV prevention among female family members and kinship networks. Curriculum based group level educational and skills building intervention Offers individual and family counseling. Offers on site free, confidential, women-focused HIV testing for persons interested in knowing their status

SISTA + SISTERACT African American girls and women ages 12- 18 & 30 + 10 bi-weekly sessions (3.5 hours each) Core subject areas: SISTA core subjects plus: Intergenerational communication skills What do mothers pass to their daughters Knowledge of our bodies and ownership of our sexuality HIV risks specific to African American women ages > 30 and youth ages 12-17 Skills-building around advocacy for individual health and safer sex African American women ages 18-29 5 weekly sessions (2 hours each) Core subject areas: Ethnic & gender pride, HIV/AIDS Education, Assertiveness Skills Training, Behavioral Self Management & Coping Skills Culture- and gender-appropriate materials to acknowledge and enhance self-pride and self-worth Discuss the cultural and gender triggers that may make it challenging to negotiate safer sex.

SISTA + SISTERACT Teaches women proper condom-use skills Teaches women sexual assertion skills Emphasizes the importance of the partner’s involvement in implementing safer sex practices SISTA Staff: 2 peer facilitators Small groups Uses movie clips & documentaries, discussion & role plays to educate about HIV risk, behaviors, and prevention Reinforces sexual education and assertion skills through performing arts Emphasizes the importance of Family Time Behavioral Health Therapist present at all group sessions SISTERACT Staff: 3 facilitators, 2 peer leaders, volunteers, Large groups of women

SISTERACT Goals Develop healthy communication skills to share with your family. Increase your knowledge on HIV prevention and other sexual health issues Know your status. Advocate for HIV awareness among female family members and kinship networks in your community

Our Bodies

Our Voices The importance of Family Time.

Our Choices

Challenging Cultural and Gender Norms in Relationships Discussion of sex in familial setting is considered taboo The pervasive belief is women who do want to talk about sex are promiscuous SisterAct encourages women to seek wisdom, strength, and support from within the family unit by increasing familial communication about safe sex and HIV prevention. We confront media messages which reinforce attitudes, beliefs, and behaviors stereotyping our identity in our community. We encourage and reinforce positive stereotypes We challenge the misrepresentation of African American women

Challenging Cultural and Gender Norms in Relationships SisterAct works to change the gender roles and norms which exist in relationships by examining and discussing: What mothers pass to their daughters Self love & healing Female sexuality across generations Communicating about sexual health How to set your limits. How to negotiate safer sex. Assertiveness vs. non assertiveness Dating older men The male/female double standard regarding sexual activity. Women’s sexuality later in life

SISTERACT: Evaluation Comprehensive program evaluation including: Risk/Eligibility Screening Pre/post knowledge & behavior assessment Curriculum evaluation forms Facilitator evaluation forms Group observation forms Participant interviews

SISTERACT: Findings Demographics Risk In the last year 103 enrolled participants 26 youth (12-18) 52 adults (19-50) 25 seniors (50 +) Average age = 37 (moved this bullet up) Approximately 50% rely on public funding to meet basic health, housing, food needs 90% accompanied by a family member or close non-blood relative. Risk In the last year 24.6% had unprotected sex (18.2% of youth) 13.2% diagnosed with an STD (18.2% of youth) 24.6% had not previously talked to a female family member about sexual health issues (27.3% of youth) Reinforce that risk data is for the first 61 participants

SISTERACT: Results Increases in Knowledge, Attitude, Behavior & Communication I can communicate with Mom better and open up about issues that she was never aware of—things I experienced growing up but was unable to tell her. I was able to have those hard discussions and begin the healing process. “Now I can open up and communicate more with my kids about sex.” “I now see the importance of sharing things with family and listening to how each person feels.”

Lessons Learned & Next Steps Effective intervention for increasing intergenerational communication about safer sex and HIV Multi-year funding is necessary for future programming and research. Further investigation into intergenerational HIV prevention education [this can be an add-on comment to bullet 1] [in order to demonstrate knowledge/behavior change, maintenance, etc]

The Women’s Collective Thank you to The 2008 International AIDS Conference & The Office of Women’s Health, Washington, DC QUESTIONS?? Abby Charles The Women’s Collective abby@womenscollective.org www.womenscollective.org 1436 U Street NW, Suite 200 Washington, DC 20009 p. 1-202-483-7003 f. 1-202-483-7330