The Health Intervention Project: HIV risk reduction among African American women drug users.

OBJECTIVE: This article describes the Health Intervention Project, an intervention for African American women in Atlanta, Georgia, who are crack cocaine users.
METHODS: A formative phase involved ethnographic mapping of the physical and social infrastructure of the study communities and in-depth interviews with women crack cocaine users. Key findings that were incorporated into the intervention program included the exchange of sex for money or drugs, the women's experience with trauma and abuse, the role of men and male partners, the women's roles as mothers and members of extended families, their identity as African Americans, and their desire to reduce their risk for HIV/AIDS related to their drug use and sexual behavior. Individualized intervention sessions were designed to meet the women's needs. The motivation intervention emphasized self-motivation for behavioral change with the assistance of the interventionist, who facilitated the women's goal identification, action plan, and problem-solving skills. The negotiation intervention focused on improving technical and assertive communication skills. An action plan was developed, and the women worked on negotiation skills, self-control regarding sexual and drug-use encounters, assertiveness in sexual and drug-use interactions, and conflict resolution.
CONCLUSION: Effective prevention and intervention programs must be framed within an appropriate racial, ethnic, and cultural context. Future research is needed to better understand risk in its social context, including the impact of community factors.