Effects of Microcredit on Economic and Social Outcomes of HIV Clients in Uganda

描述（由申请人提供）：在贫困和失业占主导地位的发展中国家，艾滋病毒护理和抗逆转录病毒疗法往往伴随着身体健康的恢复，不足以使许多PLHA实现经济健康。小额信贷方案有可能成为发展创收微型企业的宝贵资源;然而，小额供资机构不愿意接触艾滋病毒感染者，艾滋病毒客户通常不认为小额供资机构是他们的可行选择-导致非政府组织和艾滋病服务组织感到将小额信贷服务纳入其方案的压力，因为这些服务可能需要量身定制，以满足艾滋病毒携带者/艾滋病患者的需求。不幸的是，很少有关于小额信贷对这一群体的影响的出版文献来指导这些努力。小额信贷和创收方案可以发挥关键作用，使客户能够养活自己和家人，但也会增加无力偿还贷款者的债务和经济脆弱性。根据社会认知理论和资产理论，拟议的项目将探讨小额信贷服务对乌干达艾滋病毒感染者及其家庭经济状况的影响，以及经济状况的变化如何与身心健康、社会福祉（上学率、家庭连续性）和性风险行为（商业性行为、使用避孕套）相关联。这项研究将分两个阶段进行，将在三个为艾滋病毒感染者服务和提供小额信贷服务的组织进行。第一阶段将包括对艾滋病毒客户和项目管理员的半结构化采访，以探索这些小额信贷项目的运作方式以及客户在经济和社会影响方面的经验。第二阶段是一项前瞻性队列研究，将采用鼓励性设计，在6个月内跟踪180名接受或不接受小额信贷援助的艾滋病毒客户。拟议的研究将⑴提供关于小额信贷对客户及其家庭的社会经济影响的数据，无论是正面的还是负面的，⑵查明客户、家庭和方案结构的特点，这些特点与能否受益于小额信贷有关，以及（3）确定经验教训，为今后制定和测试干预措施提供信息，以提高小额信贷服务目标的有效性PLHA。 公共卫生相关性：这项研究对公共卫生很重要，因为它将提供关于小额信贷对艾滋病毒感染者的影响的经验信息，以及与小额信贷利益有关的因素，从而为制定干预措施提供信息，这些干预措施旨在最大限度地扩大小额信贷对资源有限环境中的艾滋病毒感染者的经济和社会利益。

DESCRIPTION (provided by applicant): The restored physical health that often accompanies HIV care and ART is insufficient to enable many PLHA to achieve economic health in developing countries where poverty and unemployment are dominant. Microcredit programs have the potential to be a valuable resource in developing income generating microenterprises; however, microfinance institutions (MFIs) have shown reluctance to reach out to HIV-infected individuals, and HIV clients typically do not see MFIs as a viable option for them-- resulting in NGOs and ASOs feeling the pressure to incorporate microcredit services into their programs, as such services may need to be tailored to meet the needs of PLHA. Unfortunately, there is very little published literature on the effects of microcredit in this population to guide these efforts. Microcredit and income-generation programs can play a critical role in enabling clients to provide for themselves and their families, but can also increase debt and economic vulnerability for those who are unable to repay loans. Drawing from both Social Cognitive Theory and Asset Theory, the proposed project will explore the impact of microcredit services on the economic status of HIV clients and their households in Uganda, and how changes in economic status are associated with physical and mental health, social well-being (school attendance, household continuity) and sexual risk behavior (commercial sex, condom use). The study will consist of two phases and will be conducted at three organizations that service HIV clients and offer microcredit services. Phase 1 will consist of semi-structured interviews with HIV clients and program administrators to explore how these microcredit programs function and clients' experience in terms of economic and social impact. Phase 2 is a prospective cohort study that will use an encouragement design to follow 180 HIV clients who do or do not receive microcredit assistance over 6 months. The proposed study will (1) provide data on microcredit's socioeconomic effects, either positive or negative, on client's and their household, (2) identify characteristics of the client, household and programmatic structure that are associated with success versus failure to benefit from microcredit, and (3) identify lessons learned for informing the future development and testing of an intervention to improve the effectiveness of microcredit services targeting PLHA. PUBLIC HEALTH RELEVANCE: This study is important to public health as it will provide empirical information about the effects of microcredit on people living with HIV, and the factors associated with microcredit benefits, and thus inform the development of interventions aimed at maximizing the economic and social benefits of microcredit for people living with HIV in resource constrained settings.