Efficacy of a Single-Session HIV Prevention Intervention for Black Women: A Group Randomized Controlled Trial
First Online: 05 February 2010 DOI:
10.1007/s10461-010-9672-5 Cite this article as: Diallo, D.D., Moore, T.W., Ngalame, P.M. et al. AIDS Behav (2010) 14: 518. doi:10.1007/s10461-010-9672-5 Abstract
SisterLove Inc., a community-based organization (CBO) in Atlanta, Georgia, evaluated the efficacy of its highly interactive, single-session HIV prevention intervention for black women, the Healthy Love Workshop (HLW). HLW is delivered to pre-existing groups of women (e.g., friends, sororities) in settings of their choosing. Eligible groups of women were randomly assigned to receive the intervention (15 groups; 161 women) or a comparison workshop (15 groups; 152 women). Behavioral assessments were conducted at baseline and at 3- and 6-month follow-ups. Among sexually active women at the 3-month follow-up, HLW participants were more likely than comparison participants to report having used condoms during vaginal sex with any male partner or with a primary male partner, and to have used condoms at last vaginal, anal or oral sex with any male partner. At the 6-month follow-up, HLW participants were more likely to report condom use at last vaginal, anal or oral sex with any male partner, and having an HIV test and receiving their test results. The study findings suggest that a single-session intervention delivered to pre-existing groups of black women is an efficacious approach to HIV prevention. This study also demonstrates that a CBO can develop and deliver a culturally appropriate, effective HIV prevention intervention for the population it serves and, with adequate resources and technical assistance, rigorously evaluate its intervention.
Keywords HIV prevention intervention Black women African American Condom use Sex risk behavior HIV testing References
U.S. Census Bureau. Table DP-1 General Demographic Characteristics, Data set 2007 Population Estimates. Washington, DC: U.S. Census Bureau, Population Estimates Program; 2007.
Centers for Disease Control and Prevention. Cases of HIV infection and AIDS in the United States and dependent areas, 2007, vol 19. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2009. Available at:
. Accessed April 24, 2009.
McQuillan GM, Khare M, Karon JM, Schable CA, Vlahov D. Update on the seroepidemiology of human immunodeficiency virus in the United states household population: NHANES III, 1988–1994. J Acquir Immune Defic Syndr Hum Retrovirol. 1997;14:355–60.
McQuillan GM, Kruszon-Moran D. HIV infection in the United States household population aged 18–49 years: results from 1999–2006. NCHS Data Brief No. 4. Hyattsville: National Center for Health Statistics, Centers for Disease Control and Prevention; 2008.
Centers for Disease Control and Prevention. HIV/AIDS surveillance, year-end edition. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 1990.
Hall HI, An Q, Hutchinson AB, Sansom S. Estimating the lifetime risk of a diagnosis of the HIV infection in 33 states, 2004–2005. J Acquir Immune Defic Syndr. 2008;49(3):294–7.
Centers for Disease Control and Prevention. Deaths: leading causes for 1999. Hyattsville: National Center for Health Statistics, Centers for Disease Control and Prevention; 1999.
Centers for Disease Control and Prevention. Leading causes of death in females, United States 2004. Available at:
. Accessed March 16, 2009.
Anderson RN, Smith BL. Deaths: leading causes for 2001. Natl Vital Stat Rep. 2003;52(9):1–85.
Anderson RN, Smith BL. Leading causes of death in females, deaths: leading causes for 2002. Natl Vital Stat Rep. 2005;53(17):1–89.
Reif S, Geonnotti KL, Whetten K. HIV infection and AIDS in the Deep South. Am J Public Health. 2006;96(6):970–3.
Adimora AA, Schoenbach VJ, Doherty IA. HIV and African Americans in the southern United States: sexual networks and social context. Sex Transm Dis. 2006;33(Suppl. 7):S39–45.
Georgia Department of Human Resources. Women and AIDS in Georgia. Available at:
. Accessed April 17, 2009.
Jemmott LS, Jemmott JB III, O’Leary A. Effects on sexual risk behavior and STD rate of brief HIV/STD prevention interventions for African American women in primary care settings. Am J Public Health. 2007;97:1034–40.
Sterk CE, Theall KP, Elifson KW. Effectiveness of a risk reduction intervention among African American women who use crack cocaine. AIDS Educ Prev. 2003;15(1):15–32.
Wechsberg WM, Lam WK, Zule WA, Bobashev G. Efficacy of a woman-focused intervention to reduce HIV risk and increase self-sufficiency among African American crack abusers. Am J Public Health. 2004;94:165–73.
Ehrhardt AA, Exner TM, Hoffman S, et al. A gender-specific HIV/STD risk reduction intervention for women in a health care setting: short- and long-term results of a randomized clinical trial. AIDS Care. 2002;14:147–61.
Hobfoll SE, Jackson AP, Lavin J, Johnson RJ, Schroder KEE. Effects and generalizability of communally oriented HIV-AIDS prevention versus general health promotion groups for single, inner-city women in urban clinics. J Consult Clin Psychol. 2002;70(4):950–60.
Wingood GM, DiClemente RJ, Mikhail I, et al. A randomized controlled trial to reduce HIV transmission risk behaviors and sexually transmitted diseases among women living with HIV: the WiLLOW program. J Acquir Immune Defic Syndr. 2004;37:S58–67.
Centers for Disease Control and Prevention. 2009 Compendium of evidence-based HIV prevention interventions. Available at
. Accessed May 12, 2009.
Lyles CM, Kay LS, Crepaz N, et al. Best-evidence interventions: findings from a systematic review of HIV behavioral interventions for US populations at high risk, 2000–2004. Am J Public Health. 2007;97:133–43.
DiClemente RJ, Wingood GM. A randomized controlled trial of an HIV sexual risk reduction intervention for young African American women. JAMA. 1995;274(16):1271–6.
Collins C, Harshbarger C, Sawyer R, Hamdallah M. The diffusion of effective behavioral interventions project: development, implementation, and lessons learned. AIDS Educ Prev. 2006;18(Suppl. A): 5–20.
White LD. Women of color helping ourselves: self-help methodology for wellness. Atlanta: SisterSong Women of Color Reproductive Health Collective; 2005. Available from:
. Accessed September 29, 2009.
Centers for Disease Control and Prevention. Evaluation of innovative human immunodeficiency virus (HIV) prevention interventions for high-risk minority populations. Fed Register 2004;69(134): 42183–190.
Becker MH. The health belief model and personal health behavior. Health Educ Monographs. 1974;2:324–473.
Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12:38–48.
Bandura A. Social cognitive theory in cultural context. Appl Psychol Int Rev. 2003;51:269–91.
Sillman J, Fried MG, Ross L, Gutiérrez ER. Undivided rights: women of color organize for reproductive justice. Cambridge: South End Press; 2004.
Rietmeijer CA, Fichtner RR. Toward a behavioral surveillance system for HIV/STD prevention. Atlanta: National HIV Prevention Conference; 1999.
Carey MP, Schroder KEE. Development and psychometric evaluation of a brief HIV knowledge questionnaire. AIDS Educ Prev. 2002;14:174–84.
DeHart DD, Birkimer JC. Trying to practice safer sex: development of the sexual risks scale. J Sex Research. 1997;34:11–25.
Brafford LJ, Beck KH. Development and validation of a condom self-efficacy scale for college students. J Am Coll Health. 1991;39:219–25.
Grimley DM, Prochaska JO, Velicer WF, Prochaska GE. Contraception and condom use adoption and maintenance: a stage paradigm approach. Health Educ Q. 1995;22(1):20–35.
Varnell SP, Murray DM, Janega JB, Blitstein JL. Design and analysis of group-randomized trials: a review of recent practices. Am J Public Health. 2004;94:393–9.
Lyles CM, Crepaz N, Herbst JH, Kay LS. Evidence-based HIV behavioral prevention from the perspective of CDC’s HIV/AIDS Prevention Research Synthesis Team. AIDS Educ Prev. 2006;18(Suppl. A): 21–31.
StataCorp. Stata Statistical Software, Release 8. In: College Station: StataCorp LP; 2003.
Crepaz N, Marshall KJ, Aupont LW, et al. The efficacy of HIV/STI behavioral interventions for African-American females in the United States: a meta-analysis. Am J Public Health. 2009;99(11):2069–78.
Darbes L, Crepaz N, Lyles C, Kennedy G, Rutherford G. The efficacy of behavioral interventions in reducing HIV risk behaviors and incident sexually transmitted diseases in heterosexual African Americans. AIDS. 2008;22:1177–94.
Wingood GM, DiClemente RJ. HIV sexual risk reduction interventions for women: a review. Am J Prev Med. 1996;12(3):209–17.
Beatty LA, Wheeler D, Gaiter J. HIV prevention research for African Americans: current and future directions. J Black Psychol. 2004;30(1):40–58.
Johnson BT, Scott-Sheldon LAJ, Smoak ND, LaCroix JM, Anderson JR, Carey MP. Behavioral interventions for African Americans to reduce sexual risk of HIV: a meta-analysis of randomized controlled trials. J Acquir Immune Defic Syndr. 2009;51(4):492–501.
Eldridge S, Ashby D, Bennett C, Wakelin M, Feder G. Internal and external validity of cluster randomised trials: systematic review of recent trials. BMJ. 2008;336(7649):876–80.
Adimora AA, Schoenbach VJ. Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. J Infect Dis. 2005;191(Suppl. 1):S115–22.
Farley TA. Sexually transmitted diseases in the Southeastern United States: Location, race, and social context. Sex Transm Dis. 2006;33(Suppl. 7):S58–64.
Friedman SR, Cooper HLF, Osborne AH. Structural and social contexts of HIV risk among African Americans. Am J Public Health. 2009;99(6):1002–8.
Hallfors DD, Iritani BJ, Miller WC, Bauer DJ. Sexual and drug behavior patterns and HIV and STD racial disparities: the need for new directions. Am J Public Health. 2007;97(1):125–32.
Burton J, Darbes LA, Operario D. Couples-focused behavioral interventions for prevention of HIV: systematic review of the state of evidence. AIDS Behav 2009; E-published. doi:
El-Bassel N, Caldeira NA, Ruglass LM, Gilbert L. Addressing the unique needs of African American women in HIV prevention. Am J Public Health. 2009;99(6):996–1001.
Morris M, Kurth AE, Hamilton DT, Moody J, Wakefield S. Concurrent partnerships and HIV prevalence disparities by race: linking science and public health practice. Am J Public Health. 2009;99(6):1023–31.
Purcell DW, McCree DH. Recommendations from a research consultation to address intervention strategies for HIV/AIDS prevention focused on African Americans. Am J Public Health. 2009;99(11):1937–40.
CrossRef PubMed Copyright information
© Springer Science+Business Media, LLC 2010