The scope and urgency of the HIV epidemic requires the development and evaluation of community-level behavior change intervention strategies. A randomized, multisite community-level HIV prevention trial was undertaken with women living in eighteen low-income housing developments in five U.S. cities. In the nine experimental condition developments, an intervention was undertaken that included identifying opinion leaders to attend risk reduction workshops and to form Women's Health Councils to carry out community events to reach all residents and support risk reduction efforts. Baseline and twelve-month follow-up risk characteristics were assessed by surveying 690 women at both time points. In comparison to women in the control condition developments, women in the community intervention developments reported significant reductions in frequency of any unprotected intercourse and increases in the percentage of condom-protected intercourse occasions. Community-level interventions that engage women in neighborhood-based HIV prevention activities can bring about reductions in HIV risk-related sexual behavior.
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