Kensington Research Institute

The Women Helping to Empower & Enhance Lives (WHEEL) Project

The Women Helping to Empower and Enhance Lives–or WHEEL–Project was a five-site cooperative agreement research and intervention program sponsored by the National Institute on Drug Abuse from 1990 until 1993. The project targeted women sexual partners of drug injectors in Boston MA, Juarez MX, Los Angeles CA, San Diego CA, and San Juan PR. By successfully recruiting nearly 2,800 women into the program, it was the largest study of its kind ever conducted at that time.

As part of the study design, women participating in The WHEEL Project completed lengthy interviews focusing on their drug use behaviors, sexual practices, HIV risk behaviors, perceived level of empowerment to govern their lives, maltreatment experiences during childhood (i.e., sexual abuse and physical abuse), maltreatment experiences during adolescence, and adulthood experiences with sexual, physical, and emotional violence. Upon completion of the interviews, women voted on which three of eight specific intervention topics they wished to receive instruction, education, and assistance, and then began their participation in the intervention process. The intervention topics from which they could choose included parenting, keeping safe from domestic violence, substance use/abuse, enhancing relationships, teaching others about risk reduction, sexuality, maintaining various aspects of physical and emotional health, and improving day-to-day life survival skills. Six months after their completion of the intervention sessions, women were reinterviewed to determine the extent to which behavioral and attitudinal changes had taken place and been sustained.

Working in close collaboration with the project officer at the National Institute on Drug Abuse and with several of the researchers and investigators associated with this study, Hugh Klein of Kensington Research Institute conducted extensive data analysis to determine what lessons could be learned from The WHEEL Project. Papers based on some of these analyses were presented at a number of national conferences, including:

	the 1994 U.S. Public Health Service Professional Association  (topic: demographically and behaviorally comparing HIV-positive and HIV-negative women in the study),
	the 1994 Drug Use and AIDS Community Education Network National Conference  (topic: comparing risk behavior practices among pregnant and nonpregnant women),
	the 1994 Society for the Study of Social Problems annual conference  (topic: sexual abuse and adulthood level of HIV risk),
	the 1994 International AIDS Conference  (topic: overview of The WHEEL Project and its main findings), and
	the 1995 National Colloquium of the American Professional Society on the Abuse of Children  (topic: examining the interrelationship of sexual abuse, empowerment, and HIV risk practices).

Among the many important "lessons learned" from conducting this study were the following:

	Childhood and adolescent sexual and physical abuse experiences heightened women's chances of engaging in HIV-related risky behaviors in adulthood.
	HIV-related risk reductions occurred "across the board" and were not specific to the intervention topics to which women had been exposed. This may have been due to some overlapping of the content in the original intervention design, and it also may have been due to factors pertaining to self-selection regarding the intervention sessions that women received.
	Positive outcomes were obtained for women regardless of their race, although African American, Caucasian, and Latina women differed in terms of which behaviors were most significantly altered by The WHEEL Project's interventions and which factors were most predictive of risk behavior involvement.  More research needs to be done to understand the cultural influences on women's risk practices.

Interested in learning more about some of the findings of The WHEEL Project? If so, click here.