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intervention is a social-skills-building and educational intervention for adult women living with HIV. It consists of 4 four-hour sessions, which are delivered by two trained, adult female facilitators, one of whom is a woman living with HIV.

The small group sessions consist of 8-10 women living with HIV and are conducted in a community-based setting. An adaptation of the SISTA intervention,


Emphasizes gender pride

Informs women how to identify and maintain supportive social networks

Teaches coping strategies to reduce life stressors

Enhances awareness of STD transmission and HIV reinfection risk behaviors

Teaches communication skills for negotiating safe sex

Reinforces proper and consistent condom use

Distinguishes between healthy and unhealthy relationships

Defines types of abusive relationships and their effect on a woman’s ability to negotiate safer sex practices

The target population for WILLOW is heterosexual women, regardless of race or ethnicity, living with HIV/AIDS, who are 18-50 years of age and who have known their HIV serostatus for at least 6 months.

Research and Development

Wingwood, G. M., DiClemente, R. J., Mikhail, I., Lang, D. L., Hubbard-McCree, D., Davies, S. L., et al. (2004). A randomized controlled trial to reduce HIV transmission risk behaviors and STDs among women living with HIV: The WILLOW program. Journal of Acquired Immune Deficiency Syndromes, 37, S58-S67.

CDC Program Review Panel Guidelines requires all CDC-funded agencies using the WILLOW intervention to identify or establish and utilize a Program Review Panel and complete Form 0.1113 to document this activity. The intervention researchers and developers are not involved in this activity. This is a CDC requirement for their grantees, and all questions in this regard should be directed to your agency’s CDC Project Officer or to the health department funding your agency’s implementation of the intervention. Program Review Panel Guidelines, instructions for completion of Form 0.113, and the form itself are available at the CDC Effective Interventions website.

CDC Policy on Youth Peer Outreach Workers CDC funded (directly or indirectly) agencies using youth (either paid or volunteer) in program outreach activities need to use caution and judgement in the venues/situations where youth workers are placed. Agencies should give careful consideration to the “age appropriateness” of the activity or venue. Additionally, agencies should comply with all relevant laws and regulations regarding entrance into adult establishments/environments. Laws and curfews should be clearly outlined in required safety protocols developed and implemented by agencies directly and indirectly funded by CDC. If you have specific questions, please contact your CDC project officer. For more information:

WILLOW Resources & Tools

WILLOW Fact Sheet

WILLOW Training Specifications 

Willow Core Elements:

Conduct small group interactive sessions that are supportive and meet the goals of the intervention.

Implement WILLOW with heterosexual women 18-50 years of age who are living with HIV/AIDS and who have known their HIV serostatus for at least 6 months in settings that offer HIV/AIDS services to HIV-positive women.

Use two skilled adult female facilitators to implement WILLOW sessions, at least one of whom is a woman living with HIV/AIDS. Use materials that are gender and culturally appropriate to foster self-worth and self-efficacy.

Train women in coping, decision making, goal setting, condom negotiation, and proper condom use skills, all of which are supportive of safer sexual behaviors.

Teach women about social support networks, STD and HIV reinfection, and educate women about consistent and proper condom use to support their decision making about sexual health issues.

Inform women about the aspects of healthy and unhealthy relationships and types of abuse as related to the negotiation of safer sexual practices.

Use an educational and informational focus in the sessions as opposed to a counseling and services provision focus.