CENTER FOR AIDS INTERVENTION RESEARCH (CAIR)
AN HIV PREVENTION PROGRAM FOR AT-RISK WOMEN IN INNER-CITY
PRIMARY CARE CLINICS 

Program Description

Narrative Description of Program

AIDS is now the third leading cause of death among adult American women under the age of 45, and impoverished, inner-city minority women are disproportionately threatened by HIV disease. In the absence of an effective HIV protective vaccine, efforts to curtail HIV infection require individuals to make and then sustain changes in behavior practices that confer risk. To have greatest public health relevance, HIV prevention must also be focused on persons at greatest risk for the disease. However, there have been few carefully evaluated health promotion interventions specifically for disadvantaged minority women, and fewer still focused on HIV prevention issues.

Beginning in 1991, and with grant support provided by the National Institute of Mental Health, we developed a small-group HIV prevention intervention model. The program consists of a series of five 90 minute weekly group sessions, each attended by 12 to 15 women and led by two female facilitators. The program was initially offered at the Milwaukee Indian Health Board clinic, a primary care clinic that serves largely unemployed minority women and their children. The intervention, based on social cognitive behavior change principles, includes the following elements: (1) HIV risk education, focused particularly on correcting misconceptions about AIDS risk to women and their children; (2) sexual decision making, which encourages women to identify and problem solve ways to handle "triggers" that can lead to risky encounters including substance abuse, sexual coercion, or loneliness; (3) risk reduction skills building, including practice in assertively handling pressures to engage in unwanted sex, communicating AIDS concerns, insisting on condom use, and managing personal circumstances that contribute to risk; and (4) change empowerment, in which women support one another's change efforts.