Longitudinal effects of an HIV testing and counseling programme for low-income Latina women

The purpose of this study was to assess the effects of an HIV antibody testing, counseling and education programme on the knowledge and practices of low-income Los Angeles Latina women.

The study design was prospective and longitudinal involving pre-test, post-test and retest measures over a 2-year period. The study employed an experimental group and a comparison group which did not receive the intervention. The study group was comprised of a convenience sample of 508 low-income Latina women who were recruited from the Public Health Service nutrition programme for women, infants and children (WIC). The comparison group (n = 51) was recruited from the same setting. A battery of instruments was selected to measure HIV knowledge and practices, the social support received, self-esteem, the level of acculturation and sociodemographic characteristics. The instruments were administered at pre-test, 2 weeks post-test and 1 year retest. The HIV antibody serostatus was assessed at pre-test and retest. An intervention protocol based on cultural competence, women as traditional health care givers and the major transmission categories was provided after the pre-test and was reinforced post-test. Finally, qualitative data were collected from the focus group participants (n = 55) to evaluate the intervention protocol.

The participants in the study made significant improvements in HIV knowledge and reported condom use practices from pre-test to post-test that were retained on retest. The comparison group subjects did not make significant pre-test-post-test improvements on these measures.

It should be noted that the changes in practices made by the study group did not necessarily reduce their risk of HIV infection or transmission and were not related to the demonstrated knowledge and skills improvement. Of special significance to programme planners, educators and researchers, both the quantitative and qualitative data revealed problem areas with the intervention protocol related to cultural norms and the possible fragmentation of information based on the behavioral transmission categories.