" Evaluating a Microeconomic Intervention for High Risk Women in India"

“评估针对印度高危女性的微观经济干预措施”

• 批准号: 7928435
• 负责人: Susan G. Sherman
• 金额: $ 60.56万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-28 至 2012-10-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7928435
• 关键词: AIDS prevention; Address; Adult; Attention; Biological; Chlamydia; Client; Costs and Cost Analysis; Counseling; Data; Data Collection; Economic Factors; Economics; Education; Educational process of instructing; Ethics; Ethnography; Evaluation; Feasibility Studies; Feeling; Female; Foundations; Gender; Gonorrhea; HIV; HIV Infections; HIV/STD; High Prevalence; High Risk Woman; Hour; Household; Human immunodeficiency virus test; Incidence; Income; India; Individual; Industry; Intervention; Intervention Studies; Lead; Learning; Length; Maps; Marketing; Mediating; Occupational activity of managing finances; Occupations; Outcome; Participant; Pilot Projects; Poverty; Pre-Post Tests; Preventive Intervention; Process; Production; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recruitment Activity; Relative (related person); Research; Risk; Risk Behaviors; Risk Reduction; Sampling; Sexual Partners; Specific qualifier value; Syphilis; Testing; Training; Trichomonas; Vagina; Visit; Woman; Work; arm; base; cost; cost effectiveness; design; economic evaluation; empowered; empowerment; experience; follow-up; instructor; interest; intervention effect; novel; peer; primary outcome; psychologic; public health relevance; self esteem; sex; sex risk; sexual relationship; skills; suburb; teacher; theories; tool

DESCRIPTION (provided by applicant): The current study aims to evaluate the effects of a novel, microenterprise randomized clinical trial intervention on HIV/STI incidence among female sex workers (FSWs) in Chennai, India. There has been a growing attention for the need to address structural factors in HIV prevention intervention research. The POWER (Promoting Opportunities for Women through Economic Empowerment) study is informed by psychological empowerment and asset theories. It is also informed by lessons learned from a randomized, pilot, feasibility study of FSWs (N=100) which taught us that women were extremely interested in learning tailoring skills and that involvement in the pilot was associated with reductions in the number of sex trade clients, an increase in licit income, and an overall increase in monthly income. This current study aims to determine the efficacy of a bag-making, tailoring microenterprise intervention compared to an equal attention control condition among FSWs (N=500) in Chennai at 6-, 12-, and 18-month follow-up on: reducing cumulative HIV/STI incidence (primary outcome) as well sexual risk behaviors (e.g., number of sexual partners and unprotected vaginal sex) (Aim 1); assessing if specified intrapersonal, interpersonal, and economic factors mediate the intervention's effect on the sexual risk behaviors (Aim 2); conducting economic evaluations to examine the intervention arm's cost, cost per HIV infection averted, and the break-even point at which point the intervention is cost saving (Aim 3); and exploring the effects of participation in the intervention arm on women's self-esteem, gender equity in their sexual relationships, and overall feeling about themselves and their household contribution (Aim 4). To achieve these aims, participants will be randomly assigned to the two arms and will be followed at 6, 12, and 18 months. Women will be recruited through targeted sampling from a range of street-based venues identified through existing data, observations, and ethnographic mapping conducted throughout data collection. The intervention will be comprised of two, individual, Project RESPECT, HIV prevention, pre- and post-test counseling sessions plus 100 hours of master tailoring training taught in small groups from experienced instructors. The equal-attention control arm will also be comprised of the two, individual, Project RESPECT sessions plus 100 hours of small group, English lessons taught by adult education teachers. All participants will be HIV/STI tested at each visit. While tailoring is distinct from sexual risk reduction, we hypothesize that providing women HIV prevention tools combined with the empowering and transformative process of learning a marketable skill among peers, will lead to sustainable STI risk reduction. PUBLIC HEALTH RELEVANCE: The current study will examine the effects of a structural intervention on cumulative HIV/STI incidence among female sex workers, namely, an economic empowerment study. Ultimately, the evaluation will provide the cost effectiveness of such an intervention as well as the impact on HIV/STI incidence and risky behaviors.

描述（由申请人提供）：目前的研究旨在评估一种新型的微型企业随机临床试验干预措施对印度金奈女性性工作者（FSW）中HIV/STI发病率的影响。在艾滋病预防干预研究中，越来越多的人关注解决结构性因素的必要性。POWER（通过经济赋权促进妇女机会）研究以心理赋权和资产理论为基础。它还告知从一个随机的经验教训，试点，FSW的可行性研究（N=100），这告诉我们，妇女非常有兴趣学习裁缝技能，并参与试点与减少性交易客户的数量，合法收入的增加，以及整体增加月收入。目前的这项研究旨在确定在金奈的FSW（N=500）中，在6个月、12个月和18个月的随访中，与同等注意力控制条件相比，制袋、剪裁微型企业干预的有效性：减少累积的艾滋病毒/性传播感染发病率（主要结局）以及性风险行为（例如，性伴侣的数量和无保护的阴道性交）（目标1）;评估特定的个人、人际和经济因素是否介导了干预措施对性风险行为的影响（目标2）;进行经济评估，以检查干预措施的成本、避免艾滋病毒感染的成本以及干预措施节省成本的盈亏平衡点（目标3）;以及探讨参与干预组对妇女的自尊、性关系中的两性平等、对自己和对家庭贡献的总体感觉的影响（目标4）。为了实现这些目标，参与者将被随机分配到两组，并在6个月、12个月和18个月时进行随访。妇女将通过有针对性的抽样从一系列街头场所招募，这些场所是通过现有数据、观察和在整个数据收集过程中进行的人种学绘图确定的。干预措施将包括两个，个人，艾滋病毒预防，测试前和测试后的咨询会议，加上100小时的大师定制培训讲授小组由经验丰富的教师。同样注意力控制组也将包括两个单独的项目“EQUECT”课程，加上100小时的小组英语课程，由成人教育教师授课。所有参与者将在每次访视时接受艾滋病毒/性传播感染检测。虽然量身定制不同于降低性风险，但我们假设，为妇女提供艾滋病毒预防工具，并在同龄人中学习可销售的技能，这将导致可持续的性传播感染风险降低。 公共卫生相关性：目前的研究将审查结构性干预措施对女性性工作者中艾滋病毒/性传播感染累积发病率的影响，即经济赋权研究。最终，评价将提供这种干预措施的成本效益以及对艾滋病毒/性传播感染发病率和危险行为的影响。