Mother-daughter power in DC program for girls

Focus on self-empowerment

The Black Women's Health Imperative in Washington, DC, has found that a two-pronged program that targets teen-age African American girls and their mothers or other family members has the potential for being a very successful, intergenerational HIV prevention approach.

"We address the whole HIV/AIDS issue for not only young girls, but also for women as an overall health issue," says Valerie Rochester, director of programs, Black Women's Health Imperative.

"Overall, we're finding that the female relationships within families are very important to young girls," Rochester says. "It's very important they can talk with their mothers or an older female family member and share feelings about boyfriends or school or their friends, and that helps to shape that self-image that is so important in reducing risk among our young girls."

The program, titled Girls Leading Our Way (GLOW), was adapted from the SiHLE curricula on the approved list of HIV prevention interventions compiled by the Centers for Disease Control and Prevention (CDC) of Atlanta, GA. It was funded through the Office on Women's Health, Minority AIDS Funding.

"It's intergenerational so the girls have a support system," says Samantha Griffin, a program assistant with the Black Women's Health Imperative.

"Everything we know suggests that not only do girls want to hear about sex and risk taking from parents, their parents are a guide and adult women need information," Griffin says.

So the program has eight weeks of sessions for girls, ages 12 to 17, and there are several separate sessions for their mothers or other adult mentors or family members.

Here's how it works:

• Girls meet as part of empowerment sessions: "We go into different sites, including charter schools, community centers, and we work with girls and their adult family members," Griffin says.

The sessions have general themes, as follows:

— Session 1: This session focuses on goal setting.

— Session 2: Called "Girls Like Me," this session discusses the general reality of the girls' lives, and what they like about being a girl; what they like about being a black girl, and what their family life is like. It also facilitates discussions about what the girls experience in school, Griffin says.

Discussion leaders also discuss how black girls value themselves and talk about the black and white dolls psychological study. In this study, initially conducted more than 50 years ago, researchers found that black girls often preferred to play with white dolls when offered a choice. When the study was repeated in the mid-2000s, the results were similar, Griffin says.

— Session 3: This session focuses on self-image, including body image and the media.

— Session 4: The girls are taught about general reproductive health, anatomy, hygiene, and puberty in this session, called "It's My Body."

— Session 5: While the first four sessions are empowerment sessions, by the fifth session, the girls are given information about their health and HIV. This session is called HIV 101.

— Session 6: This session discusses risk reductions. "We help girls evaluate their own risks and talk about what places them at risk for HIV infection, having sex, and pregnancy."

— Session 7: This session focuses on healthy communication.

— Session 8: Girls are taught about healthy interpersonal relationships, including healthy friendships within families for the younger girls and with boys for the older girls. "We help them identify what their sexual health is and talk about skills for risk reduction and how to apply these to their relationships," Griffin says.

• Mothers and other adult women role models learn how to teach their girls: Any woman who is raising a black teenage girl is invited to participate in several sessions that teach them about HIV, empowerment, and how to have a sexual risk dialogue with their teens.

"Our approach is to give information," Griffin says. "The moms are given HIV 101 training, and outside of that they're given space to talk about what it means to be a black woman, their unique stressors and pressures they're facing."

The sessions included discussions about how to speak with a teenage daughter and how to give her enough of the right information to help her make mature decisions.

There also was a special forum for these adult women in which reproductive health experts, a pediatrician, a local radio celebrity, and a mental health expert started a dialogue with the women attendees about parenting teens, Griffin says.

"They talked about their concerns, their discomfort, and how to start the conversation," she says. "We have to give all of the information the girls need, but we have to start when they're young, making it an open conversation with the girls so they feel like they can go to their adult female role model for advice."

This isn't a parenting class, but it is about how to start honest conversations with teens, she adds.

"What we hear from a lot of girls and a lot of adult women is they mostly talk about pregnancy when there is so much more information the girls need," Griffin says. "They need to have conversations about hygiene, their bodies, what they're going through, what their goals in life are, what their relationships are, what dating is like, and what a healthy relationship looks like."

When this conversation experience already exists as a basis for a trusting parent/role model — child relationship, then it's possible to talk about things like sexual risk reduction in a way that the teens will understand and accept, she adds.

The adult women also are taught HIV 101, which starts by saying that abstinence from sex and intravenous drug use are the only ways to truly prevent HIV infection, Griffin says.

"Then we talk about general reduction measures like using condoms, and we tell them how to properly use a condom and how to negotiate condom use and how to have assertive communication in relationships," she adds. "The facts about HIV are the usual of describing the fluids in which the virus is found, what HIV stands for, what AIDS stands for, and how the virus works and impacts your body."