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To the extent that perceptions of poverty-related stress, self-esteem deficits and substance abuse issues are also present, the threat of violence or the loss of a partner may appear worse than the possible contraction of a STI, even HIV.The intervention respects cultural norms, seeking neither to change culture nor to change social and economic situations that result from being poor.

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Her expertise has been sought by the National Institutes of Health and the Centers for Disease Control and Prevention for reviews of research grants and program applications.Participants were recruited from a community-based health clinic and screened for HIV/STIs, pregnancy and history of physical or sexual abuse.Among those participants who were determined to be eligible and agreed to participate, about half were randomly selected for a treatment group that received the intervention and half were selected for a control group.The adaptation is for use with adolescents with a history of STIs and abuse, and draws on health-promoting elements of African- and Mexican-American culture to help adolescents recognize the risks of STI acquisition and learn strategies to reduce sexual risk behavior.The intervention includes three components: draws on health-promoting elements of African- and Mexican-American culture to help adolescents recognize the risks of STI acquisition and learn strategies to reduce sexual risk behavior.One female leader (community health worker or women’s sexual health professional) is recommended to lead each workshop.Support groups and counseling sessions should be led by women’s sexual health professionals.The emphasis on childbearing issues is used to remind the adolescents of the benefit of reducing risk behavior or maintaining low-risk behavior to prevent STI/HIV, thereby preserving fertility and overall health to provide for children and family.The intervention stresses contraceptive use, reconsidering choice of partner, and skills training in meeting new partners with whom having and up-bringing of children would be more viable.These activities led her to be recognized as a prestigious Fellow in the American Academy of Nursing and as a Fellow in the American Academy of Nurse Practitioners.Sites that have used consists of two 3- to 4-hour workshops, three 1.5- to 2-hour support group sessions, and two or more individual counseling sessions.

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