Description of Intervention: Women and Infants Demonstration Projects

This community-level intervention aimed to modify community norms, attitudes and behaviors concerning condom use among community women by providing models of successful risk-reduction strategies adopted by members of the target population. The intervention was based on the Transtheoretical Model of Behavior Change, which recognizes that change occurs in stages. The intervention was implemented over a 2-year period in 4 inner city communities in 3 metropolitan areas (Pittsburgh, West Philadelphia, and Portland).

The intervention included 3 components: a media campaign, outreach, and community mobilization. The media campaign included frequent distribution of flyers, brochures, posters, and newsletters that told "role model" stories based on the lives of women in the local community. These role model stories presented readable and realistic accounts of women in different degrees of readiness to use condoms (i.e., stage-based stories), how they had overcome barriers or had learned from experience about the need to use condoms, and how they had progressed to more consistent condom use.

Four trained full-time outreach specialists in each city implemented stage-based outreach. Outreach was usually one-on-one but was sometimes delivered to groups. The purpose of these interpersonal contacts was to provide tailored prevention messages, encourage and reinforce behavior change, and to distribute condoms and role model stories.

Community mobilization entailed the recruitment of peers to form a network of volunteers to provide HIV information, referrals, condoms, and the role model stories. Small businesses, neighborhood organizations, and agencies were also recruited to donate services or products and to function as sites for distributing role-model stories and displaying posters and other visual materials.