Among us black1/1/2023 ![]() Unlike previously established interventions, E-WORTH was designed to specifically address the unique needs of Black women involved in the criminal justice system. The addition of content that confronts dyadic issues, like intimate partner violence, was also found to be acceptable and helpful for the development of self-protective behaviors. ![]() 4 Moreover, the use of racially and gender concordant (ie, Black women) facilitators is an effective strategy that is used by E-WORTH and these other interventions to mitigate mistrust and promote comradery. Similar interventions developed more than 2 decades ago, such as Sisters Informing Sisters About Topics on AIDS and Sistering, Informing, Healing, Living, and Empowering, have also proven effective in increasing condom use and reducing STI incidence among Black women at high risk. These findings by Gilbert et al 3 provide support for the role of comprehensive, culturally tailored behavioral interventions that tackle the complex determinants of HIV and STI risk among Black women. Condom use with main partners also significantly increased during follow-up. 3 At the 12-month follow-up visit, E-WORTH participants were found to be 54% less likely to have chlamydia, gonorrhea, or trichomoniasis detected and reported 38% fewer condomless sex acts in the prior 90 days. Approximately 49% of women reported more than 1 sexual partner in the previous 90 days, and more than 30% of women had test results positive for gonorrhea, Chlamydia trachomatis, or Trichomoniasis at baseline. ![]() 3 Among 352 participants, most of whom had low income and reported recent drug use, sexual behavioral risk was high. Among us black trial#The primary outcomes of the trial were incident STI infections and condom use during a 12-month postintervention follow-up period. 3 In addition, E-WORTH sessions contain content to specifically address challenges facing women who use substances and women experiencing physical, sexual, and/or injurious intimate partner violence. ![]() Among us black drivers#Drawing on empowerment theory and social cognitive theory, E-WORTH is designed to promote self-efficacy, sexual negotiation, and resilience in response to the structural drivers of HIV risk among women, including poverty, racism, discrimination, and gender inequity. In the study by Gilbert et al, 3 the authors conducted a randomized clinical trial to test the effectiveness of Empowering African-American Women on the Road to Health (E-WORTH), a hybrid individual- and group-level, multisession, culturally tailored intervention vs a streamlined HIV testing control condition to decrease HIV and STI risk among Black women in community corrections. Development, evaluation, and scale-up of novel, evidenced-based interventions to reduce HIV and STI risk in this at-risk population are needed and are critical to ending HIV among women in the US. 2 Black women who have a history of criminal justice system involvement, including those in community corrections (ie, probation, parole and other programs within the criminal justice system, but external to prisons and jails) are at particularly high risk. 1 Furthermore, the rates of sexually transmitted infections (STIs) are highest among Black women and are increasing. ![]() 1 Notably, although the rate of new infections among Black women has decreased over time, the decline has plateaued in recent years. Black women continue to be disproportionately impacted by HIV, accounting for nearly 60% of new HIV infections in US women, despite making up less than 15% of the female population. ![]()
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