Women's leadership training institute and HIV prevention training institute (WLTI-HIV/AIDS): Empowering women through leadership to prevent HIV

Background: HIV risk behaviors and HIV infection are significant public health problems among women with co-occurring substance abuse and mental health disorders with a history of trauma. However, most HIV prevention interventions have not adequately addressed this population. WLTI-HIV/AIDS is an empowerment-based leadership training program (five sessions, 4.5 hours/session) designed to reduce risky sexual behavior among women with co-occurring substance use and mental health disorders. Based in Boston, WLTI aims to build leadership qualities and skills including: self-efficacy/advocacy, problem solving and negotiation to reduce sexual risk behaviors and ultimately HIV/AIDS.

Methods: 95 women enrolled in the Boston Public Health Commission's substance abuse treatment programs were recruited (N= 49 WLTI-HIV/AIDS; N= 46 control group). Data were obtained via structured interviews at baseline, 3-, and 6-months post-intervention.

Results/Conclusions: Findings indicate that WLTI participants demonstrated increases in HIV knowledge, small increases in HIV-related self-efficacy, decreases in perceived risk for HIV, greater abstinence and less risky sex over time compared to women in the comparison condition. Results from a focus group with WLTI participants suggest that the program taught women about STIs in an accessible way, helped women incorporate conversations about HIV risk into their relationships, and helped them make decisions about risky sexual relationships. While the study was underpowered to detect statistical significance, trends from latent growth modeling indicate that incorporating leadership training into HIV education may be a potential strategy to reduce HIV risk among women with co-occurring substance abuse and mental health disorders.