Replicating Effective Programs Plus
The Future Is Ours (FIO): A Group-Level HIV Risk-Reduction Intervention for Women at Sexual Risk
The Science behind the Package
The Future Is Ours (FIO) is a small-group HIV prevention intervention delivered to high-risk heterosexual women in eight two-hour sessions. FIO is guided by three major theories: Modified AIDS Risk Reduction Model (M-ARRM), Social Cognitive Theory, and Gender Script Theory. The goal of FIO is to empower women to reduce unsafe sexual encounters by increasing the use of male and female condoms and alternative protection strategies including sex without penetration. The intervention emphasizes getting tested for HIV jointly with a partner, accepting mutual monogamy and adhering to a safety agreement. It strengthens women’s ability to make choices to decide to be celibate, to refuse unsafe sex, or to decide not to get involved with a partner who refuses to use condoms.
Heterosexually active, at-risk women of diverse ethnicities (African-American/Black, Caribbean, Latina, White), between 18 to 30 years old, who meet the following criteria:
- have unprotected sex with men
- not injection drug users
- HIV-negative or of unknown status
- not pregnant or trying to become pregnant
- living in communities where rates of HIV and other STDs are high
FIO is a small group, gender-specific, cognitive behavioral intervention that consists of eight two-hour interactive sessions. The intervention brings together groups of eight to twelve women to build group cohesion and support to allow women to connect with each other by sharing their feelings about relationships with men, values and personal vulnerability. It also teaches them to understand and personalize their risk for HIV and other STDs, identify gender-based barriers to safer sex, and gain practical knowledge and skills of a range of risk-reduction strategies. The group sessions are facilitated by two women, at least one of whom should match the ethnic background of the majority of participants, in an enclosed space that is conducive to confidentiality, but large enough to allow the participants to move around. The sessions below are conducted once a week for two hours to allow women time to practice the material. Each session incorporates a variety of techniques including demonstrations, exercises, goal setting, group discussions, lectures, “Thanks” Chips, Feeling Thermometer, review of printed materials, multicultural role-plays, skill practice, and a video.
Session One: Why should I care about getting STDs and HIV?
Session Two: How do I avoid partners who don’t care?
Session Three: What’s the best way to protect myself?
Session Four: How can I find out if we are infected?
Session Five: How do I ask my partner to use protection?
Session Six: How do I influence my partner to use protection?
Session Seven: How do I refuse sex or unprotected sex?
Session Eight: How do I continue protecting myself and others?
In the original research, FIO was found to be effective in reducing unprotected vaginal and anal intercourse and increase the percentage of condom-protected intercourse occasions in both the short-term (one month after the eight-session intervention) and long-term (12 months after the eight-session intervention and 5 months after the intervention booster session) for intervention participants when compared to the control group. The outcome included both increasing use of male and female condoms and reducing the number of sexual contacts.
For Details on the Research Design
Ehrhardt, A. A., Exner, T. M., Hoffman, S., Silberman, I., Leu, C-S., Miller, S., & Levin, B. (2002). A gender-specific HIV/STD risk reduction intervention for women in a health care setting: short- and long-term results of a randomized clinical trial. AIDS Care, 14(2), 147-161.
A Package Developed from Science
Replicating Effective Programs (REP) is a CDC-initiated project that supports the translation of evidence-based HIV/AIDS prevention interventions into everyday practice, by working with the original researchers in developing a user-friendly package of materials designed for prevention providers. FIO is one of the REP interventions and is the product of extensive collaboration among researchers, a community advisory board, and other community agencies. The package has been field tested in several community agencies and clinics across the United States by non-research staff.
FIO Core Elements
Core Elements are intervention components that must be maintained without alteration to help ensure program success.
The core elements of FIO are:
- Enable women to personalize their risk for HIV and other STDs and identify gender-related barriers to safer sex
- Encourage women to prioritize safer sex
- Reinforce women’s sexual and relationship rights
- Affirm a positive view of women’s sexuality and safer sex
- Emphasize that women have choices in how to protect themselves
- Provide accurate information about HIV/STD risk and testing
- Build skills for safer sex
- Teach women how to address negative reactions and resistance to safer sex, to recognize and deal with relationship violence and other forms of abuse
- Program Manager Guide
- Facilitators Guide with Participant Workbook an accompanying video
- Starter Kit with an Implementation Plan
- Technical Assistance Guide
- Marketing Brochure
- CD of intervention materials
Timeline for Availability
The package is available from CDC along with training on program implementation and technical assistance.
For More Information on the FIO Intervention Package
To find out more about future trainings, please visit http://effectiveinterventions.org.