International AIDS Conference July 25, 2012

1. Phenomenal Woman: The Development of a Program with the Dual Goals of Substance Abuse Relapse and HIV Prevention International AIDS Conference July 25, 2012 Authors: Cathy Irizarry, Chantay Jones, Dr. Constance West, Dr. Brenda Adjei, & Danielle Nordlund(Presenter: Dr. Constance West)

2. Presentation Outline • Background • Agency Overview • HIV Risk in Served Populations • Methods: Formative Phase • Major Activities • Lessons Learned & Decisions Made • Results • Content and Structure of Intervention • Preliminary Outcomes • Conclusions

3. Background

4. Greenhope Services for Women, Inc. • Established in 1975 • Located in East Harlem, New York City (U.S.A.) • Provides a wide array of services to women (particularly, African-American and Hispanic women with substance abuse issues and criminal justice system involvement)

5. HIV Risk Factors for Population Served • In general, substance abusers (particularly, injection drug users, commercial sex workers, and females) have been found to be at increased risk for infection with HIV and other STI’s. • HIV infection rates among individuals involved in the U.S. criminal justice system can be 2 to 5 times larger than that in the surrounding community(NIDA, 2010).

6. * New York City's AIDS case rate is almost 3 times the U.S. average. *During the first half of 2011, African-American and Hispanic women accounted for 93% of new HIV/AIDS cases among New York City women. Source: New York Department of Health and Human Hygiene (2012) HIV Prevalence Rates: New York

7. Addressing the HIV Prevention Needs of Greenhope Clients: Brainstorming the Intervention

8. Securing Funding for the Proposed HIV Prevention Program • In 2010, Greenhope received funding under the GENERATIONS (GEN III) Program • 3 Proposed Target Populations • HIV-Negative Incarcerated Women (Riker’s Island) • HIV-Negative Women at Greenhope • HIV+ Women • 2 Proposed Implementation Sites • Riker’s Island (prison) • Greenhope Facility

9. Methods

10. Formative Phase Activities

11. Formative Phase Findings & Key Decisions: Target Population

12. Formative Phase Findings & Key Decisions:Selection & Adaptation of Curriculum

13. Results

14. The Naming of “Phenomenal Woman”

15. Phenomenal Women Overview • HIV Prevention Program for Women in Recovery • Dual Goals of reducing sexual and substance abuse risk behaviors • Target Population • HIV-negative, African American and Latino female offenders (>age 18) • Ex-offenders who have substance abuse/dependence issues and at high risk for HIV • Recently released from prison and/or mandated to treatment as alternative to incarceration • Greenhope residents complete Phenomenal Woman during Orientation Phase (within 30 days of admission to Greenhope’s residential SA treatment program) OR while living in Greenhope housing and receiving intensive outpatient SA treatment

16. Phenomenal Woman Overview (Cont’d) • Implementation Strategy • Location: Sessions held on-site at Greenhope • Planned cohort size: 10-12 participants • Intervention designed to consist of 5 two-hour group sessions (conducted over 5 consecutive days), followed by a two-hour booster session held 45 days after program completion • Program designed to be implemented by a program coordinator with assistance from a part-time peer group facilitator.

17. Overview of Goals/Session Topics • Booster -Session 6 : Review key topics covered in PW and follow-up on participants experiences and achievement of goals

18. How is Phenomenal Woman Different? • Dual Purpose • Engages all 5 senses • Intensity (2 hours per day, 5 consecutive days) • Power of Repetition • Positive Woman’s Music • Affirmation Sheets • Poetry and Prayer • Relaxation Exercises (Including, use of aromatherapy and meditation rocks)

19. Phenomenal Woman: Core Elements

20. Phenomenal Woman Conceptual Model

21. Preliminary Results: Pilot/Implementation Phases • Pilot Phase (n=21participants) • High retention rates: 19/21 completed full intervention (90%) • High participant satisfaction rates: Average = 3.69 (Range 1-4) • High fidelity: 120/140 activities implemented as planned (86%) • Implementation Phase (n= 76 participants) • High participant retention rates • 100% across five initial sessions • 72% at booster session • Statistically significant increases in participants’ sense of self and knowledge of sexual anatomy. • Trends for enhanced attitudes toward condom use and relapse prevention (although not statistically significant)

22. Phenomenal Pictures and Quotes!!! “I really enjoyed the group and it was very informative, wouldn’t change a thing.” “I learned how to communicate more about having safer sex with my partner.” I learned not to regret what you did in the past and learned to love yourself…remember I'm a Phenomenal Woman.”

23. Conclusions

24. Greenhope’sPhenomenal Woman Program • Provides an example of effectively developing and delivering curricula through the adaptation of evidenced-based HIV and SA relapse prevention curricula combined with the creation of new components to more adequately address the specific needs of a target population • Maximized participant retention rates through high levels of administrative support • Holds considerable promise for dissemination to other agencies with similar target populations.

25. Acknowledgements: Funders & Collaborative Partners

26. Contact Information

27. Questions & Answers