Multimedia WiLLOW: HIV Transmission Reduction Among African American Women Living with HIV
Investigators: Josefina J. Card, Amie Ashcraft, John Wundes, Nikia Braxton, Gina Wingood, & Ralph DiClemente

Multimedia WiLLOW in an interactive computer-based intervention designed for African American women living with HIV that is gender relevant and culturally sensitive, based on the effective group intervention WiLLOW. The intervention incorporates elements of sexual risk reduction to reduce STI/HIV sexual transmission and to enhance psychosocial mediators and structural factors associated with preventive behaviors.

Designed for implementation in clinical or community-based settings, the two-session interactive, intervention emphasizes ethnic and gender pride, elements of sexual risk reduction, sexual negotiation skills, proper condom use, and development of partner norms supportive of consistent condom use. Each session offers multimedia learning, games and quizzes to help viewers increase and reinforce their risk-reduction awareness, knowledge, and skills. Women interact with the computer-based intervention individually and at their own speed. Only minimal staff participation is needed to implement Multimedia WiLLOW.

A recent study demonstrated the efficacy of Multimedia WiLLOW. The evaluation study (N=168) used a randomized controlled design to examine Multimedia WiLLOW's efficacy by assessing participants. Multimedia WiLLOW participants, compared to the control condition, had a significantly higher percentage of condom protected sex acts in the past 30 days (90% vs. 80%, p=.001). This greater condom use occurred with both HIV-negative (90% vs. 80%, p=.037) and HIV-positive (100% v. 70%, P=.011) partners. Women receiving Multimedia WiLLOW were also more likely to report 100% condom use (OR = .10; p=.003) and had a lower adjusted mean number of unprotected vaginal and anal sex acts in the past 30 days (.31 vs. 2.33, P=.002). In comparison to women in the control condition, Multimedia WiLLOW participants reported significantly higher levels of communication with their partners on HIV risk reduction practices (11.5 vs. 10.8, p=.052); greater sexual communication self-efficacy (36.1 vs. 34.0, p=.003); and less self-reported stress (32.3 vs. 34.3, p=.003). Participants rated the computer-delivered intervention more favorably than the standard of care condition in the four principal satisfaction categories -- enjoyment (4.69 v. 4.26, p<.001); information utility (4.76 v. 4.56, p= .018); information clarity (4.81 v. 4.58, p=.015); and held attention (4.68 v. 4.41, p=0.010). More Multimedia WiLLOW participants also reported having learned something new (96.6% v. 74.8%, P < .001) and thinking that other African American women would be interested in the prevention education they received (6.43 v. 5.92, p=.016).

System Requirements: To run the software you will need a Windows computer equipped with: 1.2 MB free hard drive space; 1Ghz processor or higher; 4 GB or more RAM; You must have administrator privileges to run and install programs on your PC; USB drive if purchasing the USB version; Speakers or headphones (for privacy). Note: TrueCrypt software, included as part of the WiLLOW program, is essential for running the program, and must be authorized by your organization's IT department. If you are unsure if TrueCrypt software is authorized, please check with your IT Department before purchasing.