National HIV Prevention Conference Atlanta, Georgia, USA — August 29- September 1, 1999

Natl HIV Prev Conf 1999 Aug 29-Sep 1:(abstract no. 569)
Sly DF, Montgomery DF, Riehman K, Moore TW
Florida State University, Tallahassee.

ISSUE: By the early to mid-1990s the HIV epidemic had clearly spread into the heterosexual population, and AIDS case rates and HIV infections began rising more rapidly among women than men. Largely as a reaction to these changes in the course of the epidemic, public health officials began advocating the need for interventions to protect women from infection. A major assumption of this new position was that women needed to be able to negotiate condom use with their partners. The WEAR intervention, basically grounded in social learning theory, was designed to enhance women's ability to do this.

SETTING: Women were recruited from 21 different STD, family planning and family service public health clinics and multi-service public assistance sites in the greater Miami, Florida, area.

PROJECT: The intervention consisted of six group meetings led by trained peer intervention leaders of the same ethnicity as group members. Group meetings were conducted in either English or Spanish, and although designed to be ethnically sensitive were structured to contain the same content presented in the same sequence. Intervention content included knowledge of HIV and AIDS, self assessment of risks, knowledge of condoms and their use, awareness of risk avoidance and risk reduction, self-efficacy, and assertiveness and negotiation skill building. For each group, context was emphasized through role-play activities to help booster self and ethnic pride. Recruited women were screened on site. Appointments were made with each eligible woman for a pre-test interview. Between screen and posttest, women were randomly assigned blindly to a control or experimental group. Neither the recruit nor the interviewer was aware of assignment until after the pretest interview was completed. Posttests were conducted 1 week after the completion of the intervention. Follow-up surveys were conducted at 3, 6, and 9 months following the posttest.

RESULTS: Sexual risk behaviors decreased significantly more in the experimental than the control group, and condom use increased significantly more in the experimental than the control group. Factors contributing to these changes are identified and discussed.

LESSONS LEARNED: Culturally sensitive peer interventions are indeed effective in promoting women at-risk of HIV infection to reduce risk factors. Although there was a reduction in risk factors among the experimental group, the importance of developing research designs that include male partners in HIV interventions became apparent.

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Centers for Disease Control and Prevention. National HIV Prevention Conference, 1999. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, August 29- September 1, 1999.

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