SiHLE

Developers

Ralph DiClemente, Ph.D., Gina Wingood, Sc.D. M.P.H., Kathy Harrington, Delia Lang, Susan Davies, Edward Hook III, M. Kim Oh, Richard Crosby, Ph.D., Vicki Stover Hertzberg, Angelita Gordon, James Hardin, Ph.D., Shan Parker, and Alyssa Robillard.

Program Summary

SiHLE - Sisters, Informing, Healing, Living, Empowering - is a peer-led, group-level, social-skills training intervention designed to reduce sexual risk behaviors among African-American female teenagers who are at high risk of HIV. In addition to HIV prevention, the program addresses relationships, dating, and sexual health within the specific context of the female African-American teenage experience. The program draws upon both cultural and gender pride to give participants the skills and motivations to avoid HIV and other STDs.

Intended Population

The target population is heterosexual African-American females between the ages of 14 and 18 who have had sexual intercourse and are at risk for HIV. The program was evaluated with patients at community health agencies.

Program Setting

The program was designed for and evaluated in community-based organizations and health clinics.

Contact and Availability Information

Sociometrics Corporation
1580 W. El Camino Real, Suite 8
Mountain View, CA 94040
Ph: 650-949-3282
Email: socio@socio.com
Website: https://www.socio.com/products/pasha-sihle-health-workshops-for-young-black-women

Currently no formal training offered

Sample of Curriculum Available for Review Prior to Purchase

Languages Available

English

Monitoring and Evaluation Tools

Monitoring and evaluation tools available

Yes

Monitoring and evaluation tool usage required

Information about available monitoring and evaluation tools (if applicable)

Sociometrics offers the evaluation instruments used in the original implementation of the program and the Prevention Minimum Evaluation Data Set, a generic questionnaire that can be adapted to suit most prevention programs.

Program Core Components

Last updated in 2023

The data presented on this page reflects responses from the program’s developer or distributor to a program component checklist that asked them to report on the individual components within their TPP program. The same program component checklist was sent to the developer or distributor of every active TPP program with evidence of effectiveness. The program component table provides data on seven types of program components including content, delivery mechanism, dosage, staffing, format, environment, and intended population characteristics; whether the component was present or optional in the program; whether the component is considered to be core to the program; and the lesson number or activity where the component can be found in the program. For more details, refer to the FAQ.

Category	Component	Core Component	Component present	Lesson number(s) / activities where present
Content	School engagement		No
Content	Anatomy/physiology		No
Content	Other		No
Content	Volunteering/civic engagement		No
Content	Spirituality	Yes	Yes (both versions)	Sessions 1 & 4
Content	Morals/values		No
Content	Identity development	Yes	Yes (both versions)	Sessions 1 & 4
Content	Social support/capital	Yes	Yes (both versions)	Sessions 3 & 4
Content	Social influence/actual vs. perceived social norms	Yes	Yes (both versions)	Sessions 1 & 4
Content	Social competence	Yes	Yes (both versions)	Sessions 3 & 4
Content	Parenting skills		No
Content	Normative beliefs		No
Content	Leadership		No
Content	Gender roles		No
Content	Gender identity		No
Content	Cultural values	Yes	Yes (both versions)	Sessions 1 & 4
Content	Connections with trusted adults	No	Yes (both versions)	Sessions 1 & 4
Content	Conflict resolution/social problem solving	Yes	Yes (both versions)	Sessions 3 & 4
Content	Communication skills	Yes	Yes (both versions)	Session 3 & 4
Content	Child development		No
Content	Boundary setting/refusal skills	Yes	Yes (both versions)	Session 3
Content	Substance use cessation		No
Content	Substance use - Other drugs		No
Content	Substance use - Alcohol		No
Content	Substance use - Abstinence		No
Content	Brain development and substance use		No
Content	Vocational/skills training		No
Content	Supplemental academic services		No
Content	Graduating from high school		No
Content	College preparation		No
Content	Alternative schooling		No
Content	Self-regulation	No	Yes (both versions)	Session 4
Content	Self-esteem		No
Content	Self-efficacy/empowerment	Yes	Yes (both versions)	Session 1
Content	Resilience		No
Content	Sexual health	Yes	Yes (both versions)	Sessions 1 & 4
Content	STIs - Treatment	Yes	Yes (both versions)	Sessions 2 & 4
Content	STIs - Screening	Yes	Yes (both versions)	Sessions 2 & 4
Content	STIs - Prevention	Yes	Yes (both versions)	Sessions 2 & 4
Content	STIs - Information	Yes	Yes (both versions)	Sessions 2 & 4
Content	Sexual risk reduction	Yes	Yes (both versions)	Sessions 2 & 4
Content	Sexual risk discontinuation	Yes	Yes (both versions)	Sessions 2 & 4
Content	Sexual risk avoidance	Yes	Yes (both versions)	Sessions 1 & 4
Content	Personal vulnerability		No
Content	Maternal health		No
Content	Contraception - Condoms	Yes	Yes (both versions)	Session 2 & 4
Content	Contraception - Long-acting reversible contraceptives		No
Content	Contraception - Other		No
Content	Contraception - Pills, patches, rings, and shots		No
Content	Reproduction		No

Program Objectives

The goal of the SiHLE program is to teach social skills to reduce risky sexual behaviors among participants. The program seeks to increase assertive communication skills, condom use skills, and self-efficacy.

Program Content

The four SiHLE sessions focus on educating teens on HIV transmission and risk reduction strategies by:

Developing assertive communication skills to demonstrate care for their partners and to negotiate abstinence or safer sex behaviors (particularly condom use and involvement of partners in decision-making)
Building proper condom use skills (including learning how to place a condom on a partner) and positive attitudes, norms and self-efficacy about consistent condom use
Understanding of characteristics of healthy and unhealthy relationships and the triggers that make negotiating safer sex challenging for teens, and
Empowerment and self-efficacy, based on cultural and gender pride

Program Methods

The program is delivered by one facilitator and two peer mentors through group discussion, role play, activities, and games. Review of previous information is built in throughout the sessions to reinforce knowledge and offer opportunities for questions to be answered.

Program Structure and Timeline

The program is delivered in four sessions that are each four hours long. The ideal group size is 10 to 12 participants with one adult and two peer facilitators.

The program must be delivered in community-based settings, not in school or during school hours.

Staffing

The program requires the use of one adult and two peer facilitators, all of whom should be African American and female. Peer facilitators should be between 18- and 21-years-old who, ideally, have gone through the SiHLE program. There are specific roles for the adult and peer facilitators described in the facilitator's manual.

Staff Training

There is no required training for this program. In the past several organizations have offered formal training, but none are currently specified.

Program Materials and Resources

The following program materials are available through the distributor:

User's Guide
SiHLE Facilitators Manual
Photocopy masters of posters
Participant Handbook
Photocopy masters of additional handouts, the SiHLE Jeopardy game, session evaluations
50 Domestic violence brochures
Prevention Minimum Evaluation Data Set (PMEDS)
Local Evaluator Consultant Network Directory
Original Evaluation Instruments

While a free sample curriculum is not available, providers may purchase an automatic digital download of the user’s guide to review program components, core competencies for facilitators, and scientific evidence of effectiveness. If providers decide to purchase the program, the price of the download is deducted.

Additional Needs for Implementation

Delivery of the program requires the use of condoms and penis models.

Fidelity

SiHLE has a fidelity toolkit/checklist and tools for monitoring program implementation. These may be accessed on the Sociometrics website: https://www.socio.com/products/pasha-sihle-health-workshops-for-young-black-women

Technical Assistance and Ongoing Support

Sociometrics provides telephone technical support on implementation and evaluation for one year with purchase of the program materials.

Allowable Adaptations

All adaptations must be approved by the developer, in consultation with Sociometrics.

Adaptation Guidelines or Kit

Reviewed Studies

Citation	High-Quality Randomized Trial	Low Study Rating	Did Not Meet Eligibility Criteria
DiClemente, R. J., Wingood, G. M., Harrington, K. F., Lang, D. L., Davies, S. L., Hook, E. W., et al. (2004). Efficacy of an HIV prevention intervention for African American adolescent girls: A randomized controlled trial. JAMA: Journal of the American Medical Association, 292(2), 171-179. Wingood, G. M., DiClemente, R. J., Harringon, K. F., et al. (2006). Efficacy of an HIV prevention program among female adolescents experiencing gender-based violence. American Journal of Public Health, 96, 1085-1090. Sales, J. M., Lang, D. L., Hardin, J. W., DiClemente, R. J., Wingood, G. M. (2010). Efficacy of an HIV prevention program among African American female adolescents reporting high depressive symptomatology. Journal of Women's Health, 19(2), 219-227.	✓
DiClemente, R. J., Wingood, G. M., Rose, E., Sales, J. M., Crosby, R. A. (2010). Evaluation of an HIV/STD sexual risk-reduction intervention for pregnant african american adolescents attending a prenatal clinic in an urban public hospital: Preliminary evidence of efficacy. Journal of Pediatric and Adolescent Gynecology, 23(1), 32.		✓
Klein, C. H., Card, J. J. (2011). Preliminary efficacy of a computer-delivered HIV prevention intervention for African American teenage females. AIDS Education and Prevention, 23(6), 564-576.	✓
Danielson, C. K., McCauley, J. L., Jones, A. M., Borkman, A. L., Miller, S., Ruggiero, K. J. (2013). Feasibility of delivering evidence-based HIV/STI prevention programming to a community sample of african american teen girls via the internet. AIDS Education and Prevention, 25(5), 394-404.			✓

Study Characteristics

Citation	Setting	Majority Age Group	Majority Racial/Ethnic Group	Gender	Sample Size
DiClemente, R. J., Wingood, G. M., Harrington, K. F., Lang, D. L., Davies, S. L., Hook, E. W., et al. (2004). Efficacy of an HIV prevention intervention for African American adolescent girls: A randomized controlled trial. JAMA: Journal of the American Medical Association, 292(2), 171-179. Wingood, G. M., DiClemente, R. J., Harringon, K. F., et al. (2006). Efficacy of an HIV prevention program among female adolescents experiencing gender-based violence. American Journal of Public Health, 96, 1085-1090. Sales, J. M., Lang, D. L., Hardin, J. W., DiClemente, R. J., Wingood, G. M. (2010). Efficacy of an HIV prevention program among African American female adolescents reporting high depressive symptomatology. Journal of Women's Health, 19(2), 219-227.	After school	14 to 17	African American or Black	Young women	522
DiClemente, R. J., Wingood, G. M., Rose, E., Sales, J. M., Crosby, R. A. (2010). Evaluation of an HIV/STD sexual risk-reduction intervention for pregnant african american adolescents attending a prenatal clinic in an urban public hospital: Preliminary evidence of efficacy. Journal of Pediatric and Adolescent Gynecology, 23(1), 32.	n.a.	n.a.	n.a.	n.a.	n.a.
Klein, C. H., Card, J. J. (2011). Preliminary efficacy of a computer-delivered HIV prevention intervention for African American teenage females. AIDS Education and Prevention, 23(6), 564-576.	After school	14 to 17	African American or Black	Young women	178
Danielson, C. K., McCauley, J. L., Jones, A. M., Borkman, A. L., Miller, S., Ruggiero, K. J. (2013). Feasibility of delivering evidence-based HIV/STI prevention programming to a community sample of african american teen girls via the internet. AIDS Education and Prevention, 25(5), 394-404.	n.a.	n.a.	n.a.	n.a.	n.a.

Study Findings

Evidence by Outcome Domain and Study

Citation	Sexual Activity	Number of Sexual Partners	Contraceptive Use	STIs or HIV	Pregnancy
DiClemente, R. J., Wingood, G. M., Harrington, K. F., Lang, D. L., Davies, S. L., Hook, E. W., et al. (2004). Efficacy of an HIV prevention intervention for African American adolescent girls: A randomized controlled trial. JAMA: Journal of the American Medical Association, 292(2), 171-179. Wingood, G. M., DiClemente, R. J., Harringon, K. F., et al. (2006). Efficacy of an HIV prevention program among female adolescents experiencing gender-based violence. American Journal of Public Health, 96, 1085-1090. Sales, J. M., Lang, D. L., Hardin, J. W., DiClemente, R. J., Wingood, G. M. (2010). Efficacy of an HIV prevention program among African American female adolescents reporting high depressive symptomatology. Journal of Women's Health, 19(2), 219-227.	n.a.
DiClemente, R. J., Wingood, G. M., Rose, E., Sales, J. M., Crosby, R. A. (2010). Evaluation of an HIV/STD sexual risk-reduction intervention for pregnant african american adolescents attending a prenatal clinic in an urban public hospital: Preliminary evidence of efficacy. Journal of Pediatric and Adolescent Gynecology, 23(1), 32.	n.a.	n.a.	n.a.	n.a.	n.a.
Klein, C. H., Card, J. J. (2011). Preliminary efficacy of a computer-delivered HIV prevention intervention for African American teenage females. AIDS Education and Prevention, 23(6), 564-576.	n.a.	n.a.	n.a.	n.a.	n.a.
Danielson, C. K., McCauley, J. L., Jones, A. M., Borkman, A. L., Miller, S., Ruggiero, K. J. (2013). Feasibility of delivering evidence-based HIV/STI prevention programming to a community sample of african american teen girls via the internet. AIDS Education and Prevention, 25(5), 394-404.	n.a.	n.a.	n.a.	n.a.	n.a.

KEY

Evidence Indication

Favorable findings

Potentially favorable findings

Indeterminate findings

Conflicting findings

Potentially unfavorable findings

Unfavorable findings

Note: n.a. indicates the study did not examine any outcome measures within that particular outcome domain, or the study examined outcome measures within that domain but the findings did not meet the review evidence standards.

Detailed Findings

Citation	Details
DiClemente, R. J., Wingood, G. M., Harrington, K. F., Lang, D. L., Davies, S. L., Hook, E. W., et al. (2004). Efficacy of an HIV prevention intervention for African American adolescent girls: A randomized controlled trial. JAMA: Journal of the American Medical Association, 292(2), 171-179. Wingood, G. M., DiClemente, R. J., Harringon, K. F., et al. (2006). Efficacy of an HIV prevention program among female adolescents experiencing gender-based violence. American Journal of Public Health, 96, 1085-1090. Sales, J. M., Lang, D. L., Hardin, J. W., DiClemente, R. J., Wingood, G. M. (2010). Efficacy of an HIV prevention program among African American female adolescents reporting high depressive symptomatology. Journal of Women's Health, 19(2), 219-227.	The program's evidence of effectiveness was first established in a randomized controlled trial involving sexually active African American females recruited from four community health agencies in the southern United States. Study participants were randomly assigned to either a treatment group that received the intervention or a control group that received a general health promotion intervention on nutrition and exercise. Surveys were administered immediately before the intervention and at follow- ups conducted 6 and 12 months after the intervention. Biological testing for chlamydia, gonorrhea, and trichomonas was also conducted. The study found that six months after the intervention, adolescents participating in the intervention were significantly less likely to report having a pregnancy and significantly more likely to report consistent condom use in the past 6 months. Adolescents participating in the intervention were significantly more likely to report having used a condom during last sex, reported a significantly higher percentage of condom-protected sexual intercourse acts during both the past 30 days and the past 6 months, were less likely to have had a new vaginal sex partner in the last 30 days, and reported significantly fewer episodes of unprotected sexual intercourse during both the past 30 days and the past 6 months. The study found no statistically significant impacts on self-reported condom use in the past 30 days. The study found that twelve months after the intervention, adolescents participating in the intervention were significantly more likely to report consistent condom use in the both the past 30 days and the past 6 months. Adolescents participating in the intervention were significantly more likely to report using a condom during last sex, reported a significantly higher percentage of condom-protected sexual intercourse acts during both the past 30 days and the past 6 months, and reported significantly fewer episodes of unprotected sexual intercourse during both the past 30 days and the past 6 months. The study found no statistically significant program impacts on self-reported pregnancy in the past 6 months. During the 12-month follow-up period, adolescents participating in the intervention were significantly less likely to have a chlamydia infection. The study found no statistically significant program impacts on gonorrhea or trichomonas infections.
DiClemente, R. J., Wingood, G. M., Rose, E., Sales, J. M., Crosby, R. A. (2010). Evaluation of an HIV/STD sexual risk-reduction intervention for pregnant african american adolescents attending a prenatal clinic in an urban public hospital: Preliminary evidence of efficacy. Journal of Pediatric and Adolescent Gynecology, 23(1), 32.
Klein, C. H., Card, J. J. (2011). Preliminary efficacy of a computer-delivered HIV prevention intervention for African American teenage females. AIDS Education and Prevention, 23(6), 564-576.	This study evaluated an adapted version of the SiHLE program with a randomized controlled trial involving African American female adolescents in the San Francisco Bay Area. The adapted "Multimedia" version of the program comprised two one-hour sessions delivered individually by computer. Study participants were randomly assigned to either a treatment group that received the intervention or to a control group that received a general health education session. Surveys were administered immediately before random assignment (baseline) and three months after baseline.The study examined changes in rates of sexual risk behaviors between the baseline and three-month follow-up surveys. However, the study did not test for differences in these outcomes between the treatment and control groups. The study also examined measures of condom-use self-efficacy, knowledge, sexual-communication self-efficacy. Findings for these outcomes were not considered for the review because they fell outside the review of the review.
Danielson, C. K., McCauley, J. L., Jones, A. M., Borkman, A. L., Miller, S., Ruggiero, K. J. (2013). Feasibility of delivering evidence-based HIV/STI prevention programming to a community sample of african american teen girls via the internet. AIDS Education and Prevention, 25(5), 394-404.

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