This study examined healthcare settings in Ghana in order to evaluate the effectiveness of a collaborative and participatory approach to professional training to reduce the risk of human immunodeficiency virus (HIV) transmission. 2 workshops each lasting 5 days were conducted for high-level nurse educators and leaders who could contribute to national policy development. A combination of didactics skill development sessions field experiences and development of draft national guidelines and curriculum were used. The outcomes evaluated were the pre-to-post training changes in HIV knowledge and attitudes as well as changes in practice within selected healthcare settings. 1-month follow-up visits (times not specified to participants) were used to evaluate these outcomes. At post-test significantly fewer participants thought that HIV was transmitted by saliva sweat or tears (Chi square p < .0001) and significantly fewer reported hesitation to care for an HIV-infected patient because of lack of understanding concerning mode of transmission or because of lack of supplies such as gloves (Chi square p < .01). In field observations there was an overall 42% improvement in specific infection control practices. A collaborative and participatory approach to training can result in significant changes in infection control practices even in those settings with limited resources. (authors modified)