Evaluation of a Community Developed Intervention to Reduce HIV Risk Among African American Women

In the United States, African American women are twenty times as likely as their Caucasian counterparts to become infected with HIV. At some point in her life, one in thirty-two African American women will be diagnosed with HIV. Developing and rigorously evaluating interventions to reduce the impact of this disease for African American women is thus a matter of great public health significance. The Girlfriends Project (TGP) is a community developed intervention designed to reduce HIV infection rates among African American women. TGP builds on social networks by recruiting women to host house parties for their friends and family members, during which trained facilitators provide HIV risk reduction information and on-site HIV testing and counseling. This document describes the process of scientifically evaluating TGP using a study design that was developed with community partners and took place in community settings. This pilot study used a mixed methods approach, pairing a quantitative analysis using a wait-list design with a qualitative study in which semi-structured interviews were conducted with study participants. A number of statistically significant findings were noted. As compared to the control group, women in the intervention group were four times as likely to decrease their frequency of anal sex without condoms, six times as likely to increase their frequency of anal sex with condoms, and two to three times more likely to talk with their male sex partners about preventing HIV, preventing other sexually transmitted infections, or their partners’ sex histories. Intervention group women were significantly more likely to have vaginal sex with a condom after participating in TGP and also experienced a statistically significant improvement in HIV knowledge after the intervention. Preliminary qualitative data suggests that TGP participants increase the degree to which they talk with members of their social networks about HIV risk after participating in the intervention. Participants also report that TGP has helped them to prioritize their own health and to develop connections to support other women in doing the same. Given these early indicators of success, further research is warranted to understand TGP’s mechanisms for change and demonstrate program effectiveness