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Compendium of Evidence-Based Interventions and
Best Practices for HIV Prevention

¡Cuídate! (Take Care of Yourself)

BEST-EVIDENCE

Intervention Description

Target Population
Latino youth

Goals of Intervention

  • Increase skills and self efficacy in negotiating abstinence and condom use
  • Increase abstinence
  • Increase condom use

Brief Description

¡Cuídate! (Take Care of Yourself) is a small-group, culturally based intervention to reduce HIV sexual risk among Latino youth. The intervention consists of six 60-minute modules delivered to small, mixed-gender groups. ¡Cuídate! incorporates salient aspects of Latino culture, including familialism (i.e., the importance of family) and gender-role expectations (i.e., machismo, which is described as the man's responsibility in caring for and protecting one's partner and family). These cultural beliefs are used to frame abstinence and condom use as culturally accepted and effective ways to prevent sexually transmitted diseases, including HIV. Through the use of role plays, videos, music, interactive games and hands-on practice, ¡Cuídate! addresses the building of HIV knowledge, understanding vulnerability to HIV infection, identifying attitudes and beliefs about HIV and safe sex, and increasing self-efficacy and skills for correct condom use, negotiating abstinence, and negotiating safer sex practices. The intervention curriculum is available in English and Spanish.

Theoretic Basis

  • Social Cognitive Theory
  • Theory of Reasoned Action
  • Theory of Planned Behavior

Intervention Duration
Six 60-minute modules delivered over two consecutive Saturdays

Intervention Settings
Northeast Philadelphia schools (on the weekends)

Deliverer
Trained adult facilitators, bilingual in English and Spanish

Delivery Methods

  • Demonstrations
  • Group Discussion
  • Lecture
  • Video / Music
  • Games
  • Practice
  • Role play

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Intervention Package Information

An intervention package was developed with funding from CDC’s Replicating Effective Programs (REP) Project. The intervention package is available from Select Media, Inc.

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Evaluation Study and Results

The original evaluation study was conducted in Philadelphia, PA between 2000 and 2003.

Key Intervention Effects

  • Reduced sexual activity
  • Reduced number of sex partners
  • Reduced unprotected sex
  • Increased condom use

Study Sample
The analytic study sample of 553 Latino youth is characterized by the following:

  • 100% Hispanic (85% Puerto Rican)
  • 55% Female, 45% Male
  • Mean age of 15 years, range: 13-18 years
  • Median education of 9th grade

Recruitment Settings
Three Philadelphia high schools and community-based organizations within the same neighborhoods

Eligibility Criteria
Youth were eligible if they were between 13 and 18 years old and provided assent and parental consent. Non-Latino youth (n = 103) were not excluded from participating in the intervention but were excluded from statistical analyses.

Assignment Method
Youth (N = 656) were randomly assigned to 1 of 2 groups: ¡Cuídate! (n = 312) or the Health Promotion comparison (n = 344).

Comparison Group
The Health Promotion comparison intervention focused on behaviors related to health issues affecting Latino youth, including diet; exercise and physical activity; and cigarette, alcohol, and drug use. Latino cultural values were presented to support positive health behaviors.

Relevant Outcomes Measured and Follow-up Time
Sex behaviors during past 3 months (including ever had sex, number of days had sex, frequency of sex, number of days of unprotected sex, number of sex partners, and frequency of condom use) were measured at 3-, 6-, and 12-month follow-ups.

Participant Retention

  • ¡Cuídate!:
    • 82% retained at 3 months
    • 81% retained at 6 months
    • 79% retained at 12 months
  • Health Promotion comparison:
    • 86% retained at 3 months
    • 85% retained at 6 months
    • 84% retained at 12 months

Significant Findings

  • Across the three follow-ups, intervention participants were significantly less likely to report sexual intercourse (p < .05) and multiple partners (p < .05) and reported fewer days of unprotected sexual intercourse (p < .05) compared to comparison participants
  • Among those sexually active at baseline, intervention participants were more likely to report using condoms consistently across the three follow-ups when compared to comparison participants (p < .05).
  • Among sexually inexperienced adolescents at baseline, intervention participants reported significantly fewer days of unprotected sex across the three follow-ups than comparison participants (p < .05).
  • Among Spanish speakers, intervention participants reported a greater proportion of protected sex (p < .01) and were more likely to have used a condom at last sex (p < .05), across the three follow-ups, than comparison participants.

Considerations

  • In the article by Villarruel et al. (2006), errors occurred in the symbol keys of Figures 2, 3, and 4 on page 775. The keys should have indicated that the squares represent the health promotion group and the diamonds represent the ¡Cuídate! HIV risk reduction intervention. The corrected figures can be found in the Erratum (Arch Pediatr Adolesc Med. 2006 Nov;160(11):1187).
  • The development of this intervention was based on Be Proud! Be Responsible!, an intervention targeting African American youth and tested originally with inner-city African American male youth.

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References and Contact Information

  • Villarruel, A. M., Jemmott, J. B., & Jemmott, L. S. (2006). A randomized controlled trial testing an HIV prevention intervention for Latino youth. Archives of Pediatric Adolescent Medicine, 160, 1-6.
  • Villarruel, A. M., Jemmott, L. S., & Jemmott, J. B. (2005). Designing a culturally based intervention to reduce HIV sexual risk for Latino adolescents. Journal of the Association of Nurses in AIDS Care, 16, 23-31.

Researcher: Dr. Antonia M. Villarruel
University of Michigan, School of Nursing
400 N. Ingalls, Room 4320
Ann Arbor, MI 48109-0482
email: avillarr@umich.edu

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