¡Cuídate! A Culturally Based HIV Sexual Risk Reduction Intervention for Latino Youth

The Research

The Science Behind the Package
The word ¡Cuídate!, which means “take care of yourself,” is the theme of this culturally-based program designed to reduce HIV sexual risk among Latino youth. The ¡Cuídate! Program incorporates cultural beliefs that are common among Latino subgroups and associated with sexual risk behavior. The program works to use these beliefs in a positive way to frame abstinence and condom use as culturally accepted and effective ways to prevent unwanted pregnancy and sexually transmitted diseases, including HIV/AIDS. The goals of ¡Cuídate! are to: 1) influence attitudes, behavioral and normative beliefs, and self-efficacy regarding HIV risk-reduction behaviors, specifically abstinence and correct condom use, by incorporating the theme of ¡Cuídate!—taking care of oneself and one’s partner, family and community; 2) highlight cultural values that support safer sex practices, and reframe cultural values that are perceived as barriers to safer sex; and 3) emphasize how cultural values influence attitudes and beliefs in ways that affect HIV risk-associated sexual behavior. The ¡Cuídate! program is based on Social Cognitive Theory, Theory of Reasoned Action and Theory of Planned Behavior.

Target Population
Spanish and non-Spanish speaking Latino youth aged 13 to 18 years

Intervention
The ¡Cuídate! program consists of six 1-hour modules delivered over the course of at least 2 days to groups of 6 to 10 youth. The program was originally tested in schools on consecutive Saturdays and delivered by trained adult facilitators, but it can be delivered in a variety of settings (e.g., community centers, agency field offices, schools) by a variety of agency employees (e.g., health educator, counselor, health care provider). HIV/AIDS knowledge (i.e., transmission and prevention), condom negotiation, refusal of sex, and correct condom use skills are taught to participants through the use of interactive games, group discussion, role-plays, video, music, and mini-lectures.

Research Results
The ¡Cuídate! program was tested among Latino youth in Philadelphia, Pennsylvania, and repeated in Monterrey, Mexico. In Philadelphia, youth participating in ¡Cuídate! were:

• Less likely to report sexual intercourse, multiple partners, and days of unprotected sexual intercourse
• More likely to report using condoms consistently

All effects continued 12 months after the program ended. In Monterrey, Mexico, although the majority of youth were sexually inactive, youth in the ¡Cuídate! program reported greater intentions to use condoms and contraceptives than youth in a health-promotion program.

For Details on the Research Design
Villarruel AM, Jemmott JB, III, and Jemmott LS. A randomized controlled trial testing an HIV prevention intervention for Latino youth. Archives of Pediatric & Adolescent Medicine, 2006;160: 772–777. Gallegos EC, Villarruel AM, Loveland-Cherry C, Ronis DL, and Zhou Y. Intervención para reducir riesgo en conductas sexuales de adolescentes: Un ensayo aleatorizado y controlado [Intervention to reduce sexual risk behavior in adolescents: A randomized controlled trial]. Salud Pública de México, 2008; 50(1): 59-66.

The Intervention

A Package Developed from Science
Replicating Effective Programs (REP) is a CDC-initiated project that supports the translation of evidence-base HIV/AIDS prevention interventions into everyday practice, by working with the original researchers in developing a user-friendly package of materials designed for prevention providers. ¡Cuídate! is one of the REP interventions and is the product of extensive collaboration among researchers, a community advisory board, and other community agencies. The package has been field-tested in several community agencies across the United States by non-research staff.

Core Elements
Core elements are intervention components that must be maintained without alteration to ensure program effectiveness. The core elements of ¡Cuídate! include:

1. Incorporating the theme of ¡Cuídate!—taking care of oneself and one’s partner, family and community—throughout the program.
2. Using culturally- and linguistically-appropriate materials and activities to show and emphasize core Latino cultural values, specifically familialism and gender-roles, and how those are consistent with safer sex behavior.
3. Incorporating activities that increase knowledge and influence positive attitudes, beliefs, and self-efficacy regarding HIV sexual risk-reduction behaviors.
4. Modeling and practicing the effective use of condoms.
5. Building participants’ skills in problem solving, negotiation of safe sex, and refusal of unsafe sex.
6. Delivering sessions in highly participatory, interactive small groups.

Package Contents

• ¡Cuídate! Implementation Manual including a Facilitator’s Curriculum (available in English and Spanish)
• Posters, music CD and video
• DVD containing electronic copies of materials for reproduction, such as handouts, game boards, forms and worksheets

Timeline for Availability
Development of the REP package is complete. An intervention package is currently available from Select Media, Inc. The intervention package and training will be made available by CDC in the future.

For More Information on ¡Cuídate! Package
To find out more about future trainings, please visit http://effectiveinterventions.org.

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