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Process evaluation as a tool to understand why HIV-positive women have unsafe sex: Acknowledging the voices and experiences of prevention program participants

Michelle Teti, MPH, Public Health, Drexel University, 1505 Race Street, Floor 11, Bellet Building, Philadelphia, PA 19102, 215-762-4146, mt79@drexel.edu

Issue: HIV prevention efforts recently began prioritizing the needs of people living with HIV. Because women represent a growing share of HIV/AIDS cases, evaluated interventions for HIV-positive women are necessary to decrease sexually transmitted infections and HIV transmission rates.

Description: Protect and Respect is a research project that tests two different sexual risk reduction strategies for HIV-positive women: (1) prevention messages from clinicians, and (2) messages from clinicians, a skills-based group level intervention (GLI), and Peer-led support groups. The project outcome (safe sex) is measured with a quantitative computer survey. As part of a doctoral dissertation, a student taped and transcribed the GLI and Peer groups to measure fidelity to the intervention manual and capture group processes and themes.

Lessons Learned: Collecting and analyzing process data is crucial to elucidate what happens during interventions. Specifically, in this project the process data helped explain the group intervention process, potential reasons for quantitative outcomes, and women's barriers to safer sex. Most importantly, the process data explained why women took sexual risks. This information relieved the women from blame as it uncovered the complex links between structural injustices like poverty and sexual risk behaviors.

Recommendations: HIV-prevention interventions need to perform process evaluations and disseminate process findings to clarify program outcomes and promote successful program replication. Qualitative process methodologies are particularly effective because they reveal the context of risk behavior. This includes participant's voices into the evaluation process, and provides information to refine prevention messages to address the underlying causes of women's risk behaviors.

Learning Objectives:

Keywords: HIV Interventions, Evaluation

Presenting author's disclosure statement:

Not Answered

Perspectives on HIV/AIDS & Sexual Issues

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA