Participatory action research for sustaining individual and community change: a model of HIV prevention education.

The authors describe the implementation, results, and evaluations of a participatory action research project in which they used qualitative methods to do HIV prevention education with lesbians and bisexual women. This grassroots project combined collective consciousness-raising, qualitative field interviewing, and individualized HIV prevention education in an experientially intense intervention sustained over a 2-year period in community sites. Systematic data collection about HIV risk taking among lesbians and bisexual women was conjoined with efforts to mobilize the community for behavior change to prevent HIV. A cadre of peer educators conducted 1,189 field interviews and produced 55 HIV prevention presentations with a total of 3,665 women in attendance. Key findings describe the HIV risk taking common in this population and their needs for support in reducing risk. Process evaluations of the project suggest that its combined individual and group approach and its continuity over time were effective. Outcomes suggest that the project positively affected participants' intent to change risk behaviors, supported incremental changes to reduce risk, assisted participants in the interpersonal realm of partner negotiations, and began to change community conventions about sexual expectations and practices.