Oakland Research

Oakland Collaboration: The Public Health Institute (Berkeley) and the Native American Health Center (NAHC) (Oakland)

This project evaluated the effectiveness of a women-focused intervention in decreasing HIV risk behaviors and increasing HIV knowledge for sexually active, low-income, multi-ethnic women 15 years and older who participated in a program at the Native American Health Center in Oakland. The program, “The Women’s Circle,” consisted of one-to-one, group, video and special-event sessions, scheduled over a number of weeks, that integrated HIV prevention into topics on sexual and reproductive health. This intervention was designed to enhance women’s intimate relationships and women were encouraged to attend a mix of 9-14 sessions during the project time period.

Services Provided:

  • 209 women participated in Women’s Circle activities over the project period.
  • The Women’s Circle program provided women with community health education events in a non-judgmental, information-rich atmosphere including American
  • Indian traditional activities. The program was designed to target women of childbearing ages. Participant satisfaction was high, and most Women’s Circle staff reported the intervention as successful.
  • The Women’s Circle addressed relevant topics such as self-esteem, relationships, alcohol and drugs, parenting and sexual abuse. Since a large proportion of women had experienced some form domestic violence or sexual abuse, such topics were found to need a more in-depth treatment.
  • The Circle pointed out the need for the development of social support, economic development and mental health systems in community health care.
  • Men were targeted to participate in a focus group to discuss topics similar to the Women’s Circle discussion group. NAHC staff found that men have a real interest in discussing such topics and they would likely respond to a similar group intervention.
  • The Circle helped NAHC staff learn how women utilize services, and provided additional opportunities to intervene with women in need.

Research Activities:

  • Of the 209 women who were served during the project period, 163 participants completed the pre-test and were enrolled.
  • Of those enrolled, 53% completed the post-test four months after admission. Of those, 34.9% surveyed had participated in 1-4 sessions, and 40.5% had participated in 5-19 sessions.

Summary of Research Findings:

  • Outcome evaluation was limited to the 87 women who took post the pre- and post-tests. No significant outcome effects by dose were found for several variables, including HIV risk, key HIV KAB and condom-related attitudes and behaviors.
  • In evaluating participant preference of topics addressed in the intervention, 26.4% felt they were helped the most by the sessions on self-esteem.
  • 36.8% of participants preferred the group “circle” format for type of intervention session.
  • Women reported a high rate of ongoing HIV testing, both prior to the intervention and during the intervention, and partner HIV testing.
  • Women with higher HIV risk were as likely to remain in the program as those with lower HIV risk.
  • Relationships women have are profoundly affected by poverty, uncertainty, violence and substance abuse. Interventions must be comprehensive and strive to address related issues such as education, vocational training, jobs, child care, housing, transportation, access to health care and peer support groups, and services for men and children.
  • Affected communities need to commit to changing/reducing domestic violence and sexual coercion as related to HIV prevention.

Last modified: February 24, 2011