American Journal of Public Health, Vol 90, Issue 1 57-63, Copyright © 2000 by American Public Health Association

JOURNAL ARTICLE

Outcomes of a randomized community-level HIV prevention intervention for women living in 18 low-income housing developments

KJ Sikkema, JA Kelly, RA Winett, LJ Solomon, VA Cargill, RA Roffman, TL McAuliffe, TG Heckman, EA Anderson, DA Wagstaff, AD Norman, MJ Perry, DA Crumble and MB Mercer
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, USA. kathleen.sikkema@yale.edu

OBJECTIVES: Women in impoverished inner-city neighborhoods are at high risk for contracting HIV. A randomized, multisite community-level HIV prevention trial was undertaken with women living in 18 low-income housing developments in 5 US cities. METHODS: Baseline and 12-month follow-up population risk characteristics were assessed by surveying 690 women at both time points. In the 9 intervention condition housing developments, a community-level intervention was undertaken that included HIV risk reduction workshops and community HIV prevention events implemented by women who were popular opinion leaders among their peers. RESULTS: The proportion of women in the intervention developments who had any unprotected intercourse in the past 2 months declined from 50% to 37.6%, and the percentage of women's acts of intercourse protected by condoms increased from 30.2% to 47.2%. Among women exposed to intervention activities, the mean frequency of unprotected acts of intercourse in the past 2 months tended to be lower at follow-up (mean = 4.0) than at baseline (mean = 6.0). These changes were corroborated by changes in other risk indicators. CONCLUSIONS: Community-level interventions that involve and engage women in neighborhood-based HIV prevention activities can bring about reductions in high-risk sexual behaviors.

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