This document summarizes the process of piloting the WILLOW intervention program for HIV-positive women in Ontario. It discusses how the Women's Health in Women's Hands organization selected the WILLOW program after reviewing several effective interventions. They then worked with the Ontario HIV Treatment Network to support training facilitators for the WILLOW program in Toronto. Some lessons learned from the process included that the intervention was too prescriptive, did not address all cultural issues relevant to the Canadian context, and underestimated the skill level required for facilitators. The next steps will be to pilot the intervention, evaluate it, adapt it as needed, and then scale it up more broadly.

1. David Seekings, PhD – Ontario HIV Treatment Network & REACH
Marvelous Muchenje – Women’s Health in Women’s Hands
Piloting WILLOW in Ontario

2. Overview
• The WILLOW intervention
• Our process
• Lesson Learned
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3. WILLOW
Women Involved in Life Learning from Other Women
Target Population: Heterosexual adult women living with
HIV, 18-50 years
Aim: Reduce HIV and STI transmission risk behaviours
Method: Series of 4 facilitated small group educational
sessions
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4. The process so far
• Systematic review – identified several effective
interventions
• Worked with WHIWH to select best fit to local context
• Follow up interviews with others experienced with
WILLOW
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5. Considerations for Choosing Interventions
• WHIWH received summaries of several effective
interventions from OHTN, reviewed them and selected
two (2)
1) WILLOW program by Wingood
• Aligns easily with our existing HIV program and could
easily be integrated
– We already run a monthly group for HIV-positive women
– We have smaller mental health groups
• WILLOW could fall under this structure
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6. Considerations for Choosing Interventions
2) HIV Prevention Intervention for Low-income African
American women by Dancy
• WHIWH received a 3 year funding from City of Toronto,
and we wanted to incorporate a program that has
already been found to be effective
• Intervention developed for African American women,
could fit in with our priority population
*** Plans in place to pilot test the intervention
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7. Training
• Worked with OHTN to support training for the
intervention
• OHTN offered the options for training, either go to US or
do it in Toronto
• Choice to do it in Toronto, so that we could build
capacity locally
• We invited partner agencies to recruit service providers
and peers affiliated with their organizations to
participate in the training
• A team of 16 facilitators received training
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8. Lessons Learned
• Intervention is too prescriptive
• Difficulties of separating roles of support and
information provision by facilitators
• It does not cover some of the issues that are relevant to
the Canadian context e.g. cultural issues not taken into
consideration, language specificity, migration related
issues, etc.
• Made assumptions about the skill level required for
facilitators
• Importance of a mental health therapist/counselor to
provide support on site
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9. Lessons Learned
• Can take time, even with proven intervention
– Additional capacity-building
• Importance of having good understanding of context and
capacities at the start
• Training on intervention delivery was not enough
– Additional capacity-building training
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10. Next steps
• Pilot the intervention
• Evaluate
• Adapt (as necessary)
• Scale up
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11. Thank you