IMARA: A mother-daughter group randomized controlled trial to reduce sexually transmitted infections in Black/African-American adolescents

• Published in: PloS one 2020-11, Vol.15 (11), p.e0239650-e0239650
• Main Authors: Donenberg, Geri R, Kendall, Ashley D, Emerson, Erin, Fletcher, Faith E, Bray, Bethany C, McCabe, Kelly
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adolescents; African American women; African Americans; African Americans - psychology; AIDS; Biology and Life Sciences; Caregivers; Communication; Daughters; Disease prevention; Empowerment; Female; Females; Gender; Girls; Health aspects; Health care; Health Education - methods; Health Knowledge, Attitudes, Practice; Health promotion; Health Promotion - methods; Health Risk Behaviors; Health risks; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Infections; Intervention; Male; Medical schools; Medicine; Medicine and Health Sciences; Mental health; Mothers; Mothers - psychology; Nuclear Family - psychology; People and Places; Prevention; Public health; Sexual behavior; Sexual Behavior - psychology; Sexually transmitted diseases; Social Sciences; STD; Teenage girls; Teenagers; United States - epidemiology; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0239650

Black/African-American girls are infected with sexually transmitted infections (STIs) at higher rates than their White counterparts. This study tested the efficacy of IMARA, a mother-daughter psychosocial STI/HIV prevention program, on adolescent Black/African-American girls' incident STIs at 12 months in a 2-arm group randomized controlled trial. Black/African-American girls 14-18 years old and their primary female caregiver were eligible for the study. Girls provided urine samples to test for N. gonorrhoeae, C. trachomatis, and T. vaginalis infection at baseline and 12-months. Mother-daughter dyads were randomly assigned to IMARA (n = 118) or a time-matched health promotion control program (n = 81). Retention at 12-months was 86% with no difference across arms. Both interventions were delivered over two consecutive Saturdays totaling 12 hours. Girls who received IMARA were 43% less likely to contract a new STI in the 12-month post-intervention period compared with those in the health promotion control program (p = .011). A secondary follow-up intent-to-treat analysis provided additional support for the protective effect of IMARA, albeit with a similar magnitude of 37% (p = .014). Findings provide early evidence for IMARA's efficacy, such that IMARA protected against STIs at 12-months among adolescent Black/African-American girls. Future research should examine the mechanisms associated with reduced STIs.