Mujer Segura

Mexican women, particularly those who work in high-risk professions, are overrepresented in reported cases of a variety of STDs. The dramatic increase in STDs among working women has occurred primarily in border cities. The development of risk reduction interventions tailored to women has become a priority, yet limited resources in the host country have prevented the funding of prevention programs. Over the past 18 months, researchers from the University of California, San Diego and the Universidad Aut—noma de Baja California collaborated on a pilot study that examined the feasibility of delivering a cultural and population-sensitive counseling program in Tijuana to women attending a municipal clinic specializing in STDs. Findings from this pilot suggest the feasibility of testing the effectiveness of our Spanish-version counseling program for STD risk reduction with a broad-based population of women who reside in border cities in Mexico. We have added a team of well-established Latina researchers with expertise in Mexican origin and Latina health, specifically as they relate to behavioral health issues and the impact of Mexican origin and Latina identity formation and acculturation on health outcomes. This five-year study will utilize a four-city design that includes two pairs of treatment-comparison cities ranging in size from 400,000 to 1.2 million. The four border cities are Tijuana, Ciudad Ju‡rez, Nuevo Laredo, and Matamoros. Pairs of cities will be randomly assigned to a treatment or comparison condition. Our study design will compare the effects of our STD counseling program for treatment cities (N=900) against a "standard counseling" condition (N=900) in comparison cities. Behavioral outcomes will be assessed over a six-month period. The design of the counseling program was informed by motivational interviewing, social cognitive theory, and the theory of reasoned action. Repeated-measures analysis of variance will be used to evaluate the effectiveness of the intervention. Subgroup differences in the effectiveness of the intervention will be explored based on social, contextual, and intrapersonal factors.