Since the beginning of the HIV/AIDS epidemic in the 1980s, African-Americans have faced persistent and significant disparities in diagnosis, treatment, and prevention of the disease. Of the more than 1.2 million people currently living with HIV/AIDS in the United States, approximately 44 percent are African-American, though the group makes up just 12 percent of the country's population.1 Recent data from the Centers for Disease Control and Prevention (CDC) found that African-Americans account for 64 percent of new HIV infections among women, and that the incidence rate of the disease for them is 20 times the rate among white women and 4 times the rate among Latina women.2
Georgia, and in particular, Atlanta, have seen significant negative trends in the number of HIV diagnoses in recent years. For the most recent year for which HIV diagnosis data are available, the CDC found that Georgia ranked fifth nationally3 ;and Atlanta ranked seventh nationally among all metropolitan areas.4
About SisterLove, Inc.
SisterLove, Inc., was founded as a volunteer organization in 1989 to educate African-American women in Atlanta, Georgia, about HIV/AIDS prevention, self-help, and safer-sex techniques. With a personal understanding of the barriers that kept women, and particularly women of color, out of the forefront of HIV/AIDS education, treatment, and prevention, the volunteers at SisterLove set out to improve access to those same facets of care necessary to improve health. For 27 years, the organization's mission has been to eradicate the adverse impact of HIV/AIDS and reproductive health challenges upon women and their families through education, prevention, support, and human rights advocacy in the United States and around the world.
Overview of Activities
SisterLove's Healthy Love Workshop (HLW) is a 2- to 3-hour, interactive group-level sexually transmitted disease (STD)/HIV prevention intervention delivered in a single session. The HLW is a community-focused and community-responsive workshop that speaks to the realities of African-American women's day-to-day lives, while incorporating the science of prevention to provide practical and innovative preventive strategies to help black women overcome challenges posed by HIV/AIDS. Facilitated with cultural sensitivity and understanding, the workshops, which normally have 15 participants per session, take place at a location suggested by the participants to help them to feel secure, comfortable, and confident in discussing their own sexuality and to demand safe sex behaviors from themselves and their partners.
The first component of the intervention, called "Setting the Tone," focuses on a discussion of negative words that trivialize and denigrate female sexuality, focusing on the women's feelings, attitudes, and beliefs about those words. Once the group discusses the harmful power of those negative words, the facilitator highlights positive alternative words and will use only those words for the rest of the presentation.
The second component of the intervention, called "The Facts," contains the following three exercises, including the central informational component of the workshop. In this component, first the staff facilitator writes down the acronyms "HIV" and "AIDS" on sheets of paper, and asks the participants for the meaning of each letter. This activity leads to a discussion of HIV and AIDS, and how the virus is transmitted. Second, participants learn about the most common sexually transmitted infections (STIs), their mode of transition, and typical symptoms, and then share their knowledge about STIs with other women in the group. The third and final exercise in "The Facts" dispels the myth that one can visibly tell whether someone is living with HIV or AIDS and to provide information about the incidence of the conditions in the United States. The facilitator then leads a discussion about the signs and symptoms of HIV infection and various testing options, and encourages participants to get tested and know their health status.
The third and final component of the intervention, called "Safer Sex," includes a variety of activities that allow women to practice safe sex behaviors, including an assessment of past behaviors that provides participants with information to help participants reconsider personal assumptions or beliefs regarding personal risk factors for contracting HIV or other STIs. In this section of the intervention, participants also practice key practical behaviors for safe-sex, including proper condom usage and disposal, and methods to reduce transmission of HIV and other STIs. At the end of the intervention, the staff facilitator leads participants in a card-game activity that demonstrates what they have learned about the ways HIV and other STIs are transmitted.
A recent randomized controlled efficacy trial of the HLW published in the CDC Morbidity and Mortality Weekly Report found promising results.5 The write-up examined SisterLove's efforts to both develop and evaluate the program, as well as demonstrate its effectiveness in producing changed behaviors amongst participants. Behavioral assessments conducted at baseline, 3-month, and 6-month followups showed that workshop participants had significantly increased consistent condom use and HIV testing, as well as improvements in condom use and self-efficacy, attitudes about condom use, and overall HIV knowledge compared to a control group.6
Given the reality that African-American women face a unique set of cultural and social factors impacting diagnosis, prevention, and treatment of HIV/AIDS, the HLW's results suggest that culturally tailored, interactive group intervention efforts can improve health outcomes for African-American women diagnosed with the disease. After those positive results, CDC's Office of Minority Health and Health Equity selected the intervention as an example of a program with promise for reducing HIV-related disparities in the United States. SisterLove's intervention materials are available at www.effectiveinterventions.org for use by service provider organizations interested in making strides toward addressing HIV/AIDS disparities among African-American women.
Alignment to the National Quality Strategy (NQS):
SisterLove, Inc., promotes:
- Ensuring that each person and family are engaged as partners in their care.
- The most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.
- Working with communities to promote wide use of best practices to enable healthy living.
For more information about SisterLove, Inc., contact firstname.lastname@example.org.
2 CDC. HIV Surveillance Supplemental Report, Vol. 17, No. 4; December 2012. Data are estimates and do not include U.S. dependent areas.
3http://www.cdc.gov/nchhstp/stateprofiles/pdf/georgia_profile.pdf (836.71 KB).
4http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-us.pdf (5.125 MB).