A mixed-method analysis of African-American women's attendance at an HIV prevention intervention

Grounded in a model of service utilization, this study conceptualizes attendance of African-American women at an HIV prevention intervention as associated with influences across three ecological domains - individual, service (program), and social network. First, the texts of responses to semistructured, open-ended elicitation interviews were analyzed. Survey items that conceptually matched the influences on attendance were then selected for subsequent analyses. In order to assess the contributions of groups of variables in separate domains, three blocks of independent variables were entered in a hierarchical regression. The hierarchical regression revealed that individual domain variables (age, level of education, and perception of racism) accounted for 18% of variance in attendance. After controlling for these variables, program domain variables (use of counseling and staff friendliness) accounted for an additional 7% of variance. The social network domain (influence of friends) did not account for any additional variance. It appears that several factors in different ecological domains may influence attendance at HIV prevention interventions. The modifiable factors found here can be used by researchers and practitioners to improve the attendance of racial and ethnic minority populations, those at most risk for HIV exposure, at prevention interventions.