HIV/AIDS Prevention

CDC provides prevention messages to women through community-based organizations (CBOs), school-based programs, and public information and education programs. Through health departments and CBOs, interventions such as street outreach, risk-reduction counseling, and prevention case management are focusing on women at risk for HIV. CDC's programs also include a number of activities designed to educate women, and the public in general, about how HIV is transmitted, which behaviors put them at risk of acquiring the infection, and how the infection can be prevented. These activities include the services of the CDC National AIDS Hotline and the CDC National AIDS Clearinghouse, as well as national media campaigns.

Related Research Activities

CDC is collaborating with prevention partners to conduct research on the most effective HIV prevention methods for women. While condom use by male partners remains the most effective method for heterosexually active women to avoid acquiring HIV or other sexually transmitted diseases, CDC is evaluating female-controlled methods such as the female condom and topical microbicides.

CDC also conducts extensive behavioral research to increase our understanding of the many factors that make women vulnerable to HIV infection. For example, a recent study conducted among young women who are sexually active found that those whose first sex partner was an older man were less likely to use condoms and possibly at higher risk for HIV infection than young women whose first partner was about the same age. Such social and behavioral research is critically important to researchers who develop interventions designed to prevent HIV infection, other sexually transmitted diseases, and unintended pregnancy among young women.

Additionally, CDC is conducting research to evaluate the risk of HIV infection for women who have sex with women and is continuing to work with expert consultants to develop guidance for preventing female-to-female HIV transmission. (See related article, HIV/AIDS Among Women Who Have Sex with Women.)

The following section highlights some, but not all, ongoing CDC-funded research projects focusing on women:

• Determinants/Consequences of HIV Counseling and Testing (C&T) for Pregnant Women and Perinatal ZDV Use is conducted collaboratively by Yale University, SUNY at Brooklyn, the University of Miami School of Medicine, and Duke University, with the following objectives: (1) to describe the extent to which current prenatal HIV C&T and intervention practices reflect full implementation of local and national guidelines, (2) to identify and quantify determinants of success or failure to implement guidelines for offering HIV C&T to pregnant women and determinants of accepting HIV testing by pregnant women, (3) to identify and quantify determinants of the acceptance of and adherence to preventive zidovudine therapy and the receipt of needed HIV-related services by HIV-infected pregnant women and their children, and (4) to identify and quantify social and psychological effects of being diagnosed with HIV, particularly the potential adverse social and psychological consequences for pregnant women, including discrimination, domestic violence, and loss of social and family supports.

• Evaluation of WISH: Sexual Health Seminars for Women is being conducted, in collaboration with the University of Minnesota Medical School and others, to evaluate the effectiveness of the Women's Initiative for Sexual Health (WISH) program and to determine if sexual HIV risk-reduction education, in the context of comprehensive, culturally specific sexuality education, is effective in reducing HIV sexual risk factors among low income, chemically dependent African-American women over age 18.

• Female Condom Project. The CDC awarded funds through the National Center for Chronic Disease Prevention and Health Promotion's (NCCDPHP) Prevention Centers Cooperative Agreement mechanism to the University of Alabama at Birmingham (UAB) to conduct an evaluation study of the female condom. This study complements an ongoing UAB study on the efficacy of barrier methods in preventing STDs that is funded by the National Institutes of Health (NIH). The CDC project has two separate studies -- a behavioral determinants study, which is an in-depth assessment of the behavioral predictors of and barriers to use of the female condom, and a slippage/ breakage study that is investigating the mechanical failure of the female condom.

  The goals of the behavioral determinants study are to identify the psychosocial facilitators and barriers to female condom use, to identify strategies that facilitate consistent female condom use, and to assist providers in identifying women likely to become successful users of the female condom. The study population is predominantly young African-American women at risk for STD/HIV because of a history of multiple partners and STDs; all are clients of the Birmingham and Huntsville public STD clinics. The study includes two components: a large prospective cohort study and a small cross-sectional, qualitative study.

  The purpose of the prospective cohort study is to assess the relationship between quantitatively measured psychosocial variables and female condom use patterns. The prospective cohort study began in July of 1995. Participants take part in a structured, quantitative interview at baseline and follow-up to allow project staff to assess variables.

  The purpose of the cross-sectional qualitative study is to enrich our understanding of the different patterns of female condom use. Ten to fifteen women in each of four female condom user groups will be interviewed: nonusers (women who decline to try the female condom); experimenters (women who try the method once or twice and discontinue use); and short-term and long-term consistent female condom users. Ten male partners per group will be invited to participate and will complete a qualitative interview.

• Natural History of HIV Infection and AIDS in Women (HIV Epidemiology Research/HER Study), in collaboration with the Johns Hopkins University, Montefiore Medical Center, Brown University, and Wayne State University, is designed to (1) measure the effects of HIV infection on the physical, emotional, and social health of American women, and (2) identify intervention components that may improve the quality and duration of the lives of HIV-infected women.

• WINGS: A Randomized, Controlled Trial of a Group Intervention for Women at Risk for HIV and STD, in collaboration with the Columbia University School of Public Health, the Johns Hopkins School of Public Health, and the University of Washington School of Public Health, is being conducted to determine (1) what strategies are successful for recruiting and retaining high-risk women in support groups, (2) whether structured support groups are effective in reducing risk behaviors among high-risk women, (3) whether drop-in groups following a series of six structured sessions increase the effectiveness of the intervention, and (4) whether women will attend drop-in groups without receiving monetary compensation.

Overall, the Divisions of HIV/ AIDS Prevention are conducting approximately 20 research projects focusing on women's issues, and others are ongoing throughout CDC. For additional information, contact an information specialist in the Technical Information and Communications Branch at 404-639-2076.

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