• Gina Wingood, Ph.D.

Dr. Wingood introduced and described a novel program in Alabama and Georgia for women living with HIV, namely the WILLOW program. In 1996, although the HIV epidemic was raging in Alabama among women, there were no secondary prevention interventions for women in the state funded by the Centers for Disease Control (CDC). Dr. Wingood and her associates obtained a grant to decrease depression, improve the quality of life and enhance coping strategies among women with HIV. Thus WILLOW (Women Involved in Life Learning from Other Women) was born. The program consists of four sessions each four hours long. Only females older than 18 years old with HIV infection were accepted into the program. The goals and contents of the sessions are as follows:

Session 1: Gender Pride

This session is designed to improve self esteem and sense of pride. The women are encouraged to discuss positive attributes of womanhood and identify desirable qualities and role models. They engage in values clarification and goal setting.

Session 2: Stress Management and Changing Thoughts

In this session, participants define stress and identify sources of stress that cannot be changed. They then discuss coping strategies including changing thoughts. They incorporate the RELAX model:

• Relaxation (relaxation techniques)

• Expression of self (journals)

• Letting others help

• Allowing positive thoughts

• X (exercise)

Session 3: Condom Use

The purpose of this session is to foster positive attitudes toward condom use, develop norms supportive of safer sex and dispel myths regarding condom use.

Session 4: Healthy Relationships

Healthy relationships are defined, participants are taught to recognize signs of unhealthy relationships and empowered to seek help regarding the same. Discussions of domestic violence, sex abuse, and emotional abuse form an important part of this session.

Following the fourth session, participants are followed for a year with monthly 20-30 minute telephone calls. Retention rates at 6 months and 12 months were a phenomenal 98%. Feedback from the care providers of WILLOW participants was positive, noting increased participation in care. This discussion of the program elements in itself was a reiteration of the multi-tiered issues relating to women that increase their vulnerability to HIV. Low self-esteem, external stressors and pressures, and lack of empowerment, by leading to high-risk behaviors, contribute to vulnerability as much as do biological factors. WILLOW appears to be a unique and invaluable complement to medical care. Asked about plans to expand nationally, Dr. Wingood indicated possible plans to do so should funding be available.