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Randomized Controlled Trial
. 2020 Nov 2;15(11):e0239650.
doi: 10.1371/journal.pone.0239650. eCollection 2020.

IMARA: A mother-daughter group randomized controlled trial to reduce sexually transmitted infections in Black/African-American adolescents

Geri R Donenberg  1   2   3 , Ashley D Kendall  1   2 , Erin Emerson  1   2   3 , Faith E Fletcher  4 , Bethany C Bray  1 , Kelly McCabe  1   2
Affiliations
Randomized Controlled Trial

IMARA: A mother-daughter group randomized controlled trial to reduce sexually transmitted infections in Black/African-American adolescents

Geri R Donenberg et al. PLoS One. .

Abstract

Black/African-American girls are infected with sexually transmitted infections (STIs) at higher rates than their White counterparts. This study tested the efficacy of IMARA, a mother-daughter psychosocial STI/HIV prevention program, on adolescent Black/African-American girls' incident STIs at 12 months in a 2-arm group randomized controlled trial. Black/African-American girls 14-18 years old and their primary female caregiver were eligible for the study. Girls provided urine samples to test for N. gonorrhoeae, C. trachomatis, and T. vaginalis infection at baseline and 12-months. Mother-daughter dyads were randomly assigned to IMARA (n = 118) or a time-matched health promotion control program (n = 81). Retention at 12-months was 86% with no difference across arms. Both interventions were delivered over two consecutive Saturdays totaling 12 hours. Girls who received IMARA were 43% less likely to contract a new STI in the 12-month post-intervention period compared with those in the health promotion control program (p = .011). A secondary follow-up intent-to-treat analysis provided additional support for the protective effect of IMARA, albeit with a similar magnitude of 37% (p = .014). Findings provide early evidence for IMARA's efficacy, such that IMARA protected against STIs at 12-months among adolescent Black/African-American girls. Future research should examine the mechanisms associated with reduced STIs.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Consolidated standards of reporting trials (CONSORT) summary of participant enrollment and retention at 12-month follow-up.
Fig 2
Fig 2. STI prevalence rates at each time point.
STI prevalence rates among girls with observed data at both time points at baseline (n = 18/93 in IMARA; n = 10/71 in the control group) and 12-month follow-up (n = 15/93 in IMARA; n = 17/71 in the control group). Error bars indicate the standard error of the probability within a given arm.
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