Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

HIV weakens the body’s immune system and makes it hard to fight off infections. No cure for HIV exists. Using condoms can help prevent HIV and other sexually transmitted infections, or STIs. Also, a medicine called pre-exposure prophylaxis, or PrEP, helps prevent HIV infection when taken each day.

HIV and STI prevention programs can help increase condom and PrEP use. However, these programs have not been adapted for or tested with African-born Black women. African-born Black women have the highest rate of HIV infection among Black people living in the United States.

In this study, the research team is adapting two widely used, evidence-based HIV and STI prevention programs for African-born Black women. These programs were originally designed for US-born Black women:

  • Sister-to-Sister focuses on building skills such as how to use a condom and how women can talk to their sexual partners about condom use. In this program, a health professional meets with women one-on-one for 20 minutes.
  • SISTA teaches women how to use condoms and about stigma, or negative judgments from others, when using condoms. The program uses materials that are based on African culture to help build women’s confidence in talking to their sexual partners about condom use. In this program, two peer facilitators conduct five educational sessions with a group of women. Each session lasts two hours.

The research team is comparing how well the two programs work to increase condom and PrEP use among African-born Black women.

Who can this research help?

Results may help community-based organizations and clinics when considering ways to decrease HIV risk among African-born Black women.

What is the research team doing?

The research team is first adapting Sister-to-Sister and SISTA to reflect African culture. Then, the team is recruiting 424 African-born Black women with the help of two community-based organizations in Massachusetts and New York City. The team is assigning women by chance to receive either the adapted Sister-to-Sister or SISTA program.

At the start of the study and three and six months later, women are completing surveys. Surveys ask about condom and PrEP use, women’s confidence in their ability to use condoms and talk to their sexual partners, and their HIV knowledge. At the start of the study and after six months, the research team is offering women tests for HIV, chlamydia, and gonorrhea. The team is also looking at health records for PrEP prescriptions.

African-born women are helping to adapt the programs and giving feedback about the study design.

Research methods at a glance

Design Element Description
Design Randomized controlled trial
Population 424 African-born Black women ages 18–45 who report having condom-less sex with a male in the past 3 months
  • Sister-to-Sister

Primary: condom use, PrEP uptake

Secondary: acceptance of HIV testing, new STIs, comfort using condoms, HIV-related stigma, HIV knowledge, sexual communication self-efficacy, ability to assert oneself within sexual relationships

Timeframe Timeframe Length of follow-up for collecting data on primary outcomes. View Glossary 6-month follow-up for primary outcomes

Project Information

Bisola Ojikutu, MD, MPH
Brigham and Women's Hospital
Comparative Effectiveness of Individual versus Group-Level Interventions to Reduce HIV Risk among African Immigrant Women

Key Dates

June 2020
June 2025


Award Type
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Funding Opportunity Type
Research Priority Area
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: April 11, 2022