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

Evaluation Summary

Narrative Description of Evaluation Results

Outcome Evaluation Study. To evaluate the intervention's effectiveness, 197 women over a 2 year period were randomly assigned to either the HIV prevention program or a comparison intervention that included standard AIDS counseling but otherwise focused on women's health topics unrelated to AIDS. Women in the project were predominantly African American (87%) and unemployed (97%), and most had not completed high school. All reported multiple sexual partners, injection drug use partners, or STD treatment history. Prior to participation and again at 3-month follow-up, all women were administered confidential measures assessing their AIDS risk knowledge, sexual assertiveness skills, and sexual behavior over the past 3 months. Women in the comparison group showed no change in risk. Women who attended the HIV prevention program gained in risk knowledge and risk reduction skills, reduced their rates of unprotected sex by about 20%, and increased in their use of barrier protection during sex from 26% to 56% of intercourse occasions.

Cost Effectiveness Analysis. We conducted a retrospective cost effectiveness analysis of the program. This analysis took into account the program's cost of delivery, its risk reduction behavior change impact, and factors related to statistically modeling the number of HIV infections averted. The cost of the program uses $269 per client and the base cost-utility ratio was $2,024 per discounted Quality of Adjusted Life Year saved, well within the range of sound cost effectiveness and low compared to other life-saving interventions. The project evaluation article was published in the American Journal of Public Health, and a separate article describing its cost effectiveness is in press in the same journal. Both are attached.

Community Use. Although the formal evaluated program has ended, it is being continued as a service in the clinic, as well as in Milwaukee shelters for homeless women. Program manuals are disseminated at no cost by CAIR to AIDS prevention and health organizations.