Engaging fathers to improve the reproductive health of black girls

The statistics speak for themselves: Nationwide, one in four black girls between the ages of 14 and 19 becomes infected with a sexually transmitted disease. In Chicago, STI rates are higher among black girls and women than among other ethnic groups. 56% of new HIV diagnoses are in the 13- to 29-year-old age group.

Natasha Crooks, assistant professor in UIC’s College of Nursing, wants to help improve the sexual and reproductive health of Black girls by empowering an often overlooked resource: the girls’ male caregivers. These can be their fathers, brothers, uncles, cousins ​​or other caring men in a girl’s life.

With the help of a five-year, $4 million grant from the National Institute on Minority Health and Health Disparities, Crooks is piloting a two-day workshop for girls and their male caregivers to help them better understand and talk more openly about women’s reproductive and sexual health.

“There are literally no other programs that involve male caregivers,” Crooks said, when it comes to girls’ sexual and reproductive health. “It’s about fathers and boys and mothers and girls. But that doesn’t do it justice. What about the fathers who really want to be involved? It shouldn’t be this awkward, uncomfortable conversation.”

Want to hear from men

The development of the curriculum, called IMAGE, began with Crook’s dissertation. For this project, she interviewed Black women to create a theoretical framework describing the process of becoming a sexual Black woman.

“The women talked a lot about how their childhood experiences influenced their sexuality. So I decided to interview girls,” she said.

When she did, the girls told her they wanted more support and protection, “and many specifically told me they wanted to hear the male perspective on how they could better protect themselves.”

IMAGE was created from this work.

Crooks adapted IMAGE from another curriculum called IMARA, developed by her mentor Geri Donenberg at the UIC College of Medicine. IMARA – Informed, Motivated, Aware and Responsible About AIDS – is a two-day workshop for black girls and their female caregivers to help prevent HIV infection. Crooks tailored it for male caregivers.

Programs like IMARA and IMAGE (IMARA stands for Black Male Caregivers and Girls Empowerment) focus on black girls because they are at high risk for STIs and HIV. That’s in part because puberty begins earlier for all girls than it used to be, but black girls are often among the youngest, hitting puberty at around age 9. This leads to adultization, in which black girls are treated as older than they are and are approached by older men as sexual partners, Crooks said. Having an older sexual partner correlates with an increased risk of sexual violence, STIs and HIV, she added. There are also cultural norms that discourage the use of contraception or protective measures like condom use, which can increase black girls’ risk for STIs and HIV.

Men often know more about female reproductive health than they give credit for, Crooks says. Yet IMAGE includes lessons on female reproductive biology – what a uterus is, how menstruation works – that many men said they didn’t have a comprehensive understanding of.

The majority of IMAGE focuses on improving communication and creating more comfort when talking about potentially sensitive topics such as sex, bodies and relationships.

Crooks and her colleagues — Donenberg, Phoenix Matthews, formerly of UIC and now at Columbia University, and Crystal Patil, formerly of UIC and now at the University of Michigan — tested IMAGE two summers ago with 40 girl-mentor pairs in the North Lawndale AMACHI Mentoring Program. Both the men and girls in the program said IMAGE helped them overcome many uncomfortable feelings about talking about these issues.

“They can communicate a little better and it improves their relationship,” Crooks said.

Crooks learned that the men on the show wanted to address issues rooted in structural racism, such as the disproportionate incarceration rate and the lack of positive male role models for black men. For example, IMAGE includes discussions about how incarcerated men can still provide guidance and protection for the girls in their lives.

And even after the pilot program, many of the men wanted to continue to be able to talk to each other about issues like mental health in a safe environment. Crooks helped create that space at the North Lawndale location.

New project this summer

Starting this summer, Crooks and her colleagues will work with six nonprofits that serve predominantly Black neighborhoods on Chicago’s South and West sides. To further test IMAGE’s effectiveness, they hope to recruit 300 girls and their male caregivers who will be randomly assigned to participate in either IMAGE or another health program. Both two-day programs will meet on Saturdays and Sundays.

The researchers will compare outcomes for the girls in the two groups. They will look at risk factors for STIs, such as condom use and the number of sexual partners a girl has, as well as the incidence of STIs six and 12 months after the program. They hope to use what they learn to improve IMAGE, which they hope will continue to be offered by community partners.

“The goal is for the community to own this program,” Crooks said, “and for IMAGE to continue without us.”

Visit the IMAGE website to learn more about the study. Interested parties can email the researchers at [email protected].