HIV prevention education for lesbians and bisexual women: a cultural analysis of a community intervention.

AIDS is increasing almost four times as fast among women, yet lesbians and bisexual women are among the least studied, least understood and most elusive populations affected by the AIDS epidemic. This paper reports the results of community-level HIV prevention research designed: (a) to examine the knowledge, perceptions, social contingencies and political constraints affecting the HIV risk taking of lesbians and bisexual women; and (b) to offer them context specific HIV prevention education. The study was a peer educator-based intervention project situated in San Francisco's women's bars, dance clubs, and sex clubs to reach socially and sexually active lesbians and bisexual women in natural settings. Between June 1992 and May 1993, ethnographic interviews were conducted with 626 women attending the bars and clubs; group presentations at these locales reached 1,315 women. The structure of the intervention was effective in prompting interest in HIV prevention information and intent to change behavior. The resultant cultural analysis details risk behaviors lesbians and bisexual women participate in, myriad constraints they face in trying to enact safer behaviors, gaps in knowledge, difficulties comprehending the relevance of HIV prevention, and risk reduction strategies commonly employed.