A Review of HIV Interventions for At-Risk Women

This paper reviews published reports on primary prevention of sexual transmission of HIV with women from the beginning of the AIDS epidemic through March 1996. All reviewed interventions were conducted in the United States, Canada or Puerto Rico and the reports described a psychological, behavioral, or educational component specifically to address sexual risk reduction and included a behavioral evaluation component. Manual and computer searches identified 47 studies that targeted women and provided a female-specific analysis of intervention effects. Sixteen of the 47 studies fulfilling more rigorous methodological reporting standards were considered separately. Overall, the findings demonstrate that HIV prevention programs can be effective in reducing risky sexual behavior among at-risk women. Program effectiveness varied by intervention type, session duration, and whether studies included women alone or both men and women. The most efficacious HIV prevention programs were specifically directed toward women, focused on relationship and negotiation skills, and involved multiple, sustained contacts. Evidence also indicated that community-level interventions hold promise. This review includes a methodological critique, identification of research gaps, and recommendations for future intervention research with women.