Evaluating a Microfinance Intervention for High Risk Women in Mongolia

描述（由申请人提供）：拟议的研究代表了储蓄主导的小额信贷干预与艾滋病预防相结合的第一次试验，以减少女性性工作者（FSWs）的性风险行为。这项研究可能会推进针对全球面临艾滋病毒和性传播感染风险的妇女的针对性别的预防方案。更具体地说，美国/蒙古合作研究团队将：(1)将社会认知和资产理论整合到小额信贷干预的开发和实施中，以促进妇女降低艾滋病毒风险和经济自给自足；(2)测试基于资产理论的多种基于证据的小额信贷组成部分（金融知识、业务发展培训/指导和匹配储蓄）的组合，以促进降低艾滋病毒风险和经济自给自足；(3)通过(a)提供个人理财知识和业务管理方面的大量培训（大多数小额信贷机构不提供这些培训），测试对金融服务人员独特需求敏感的小额信贷模式；(b)在向妇女介绍贷款项目之前，向她们介绍信贷风险；(c)提供相应的储蓄，为业务发展建立资产；(4)首次测试具有匹配储蓄成分的小额信贷是否可以影响低收入国家性工作者的性风险降低。我们将随机分配134名符合资格标准并完成基线评估的fsw，将其分为基于证据的艾滋病毒性风险降低干预(HIVSRR) +小额信贷（HIVSRR+MF）或单独的HIVSRR作为对照条件，在测试后立即，干预后3个月和6个月进行随访评估。有证据表明，这种小额信贷和预防艾滋病毒的结合可能更有可能降低妇女的风险，因为她们依赖性行为作为经济支助手段，因而无法关注艾滋病毒或性传播感染等长期健康后果。本研究回应了文献中确定的需要，即严格测试小额信贷和艾滋病毒预防相结合的方法，以支持妇女减减性风险，因为基于个体的干预措施过于有限，性别、经济和移民问题限制了现有预防干预战略的影响。

DESCRIPTION (provided by applicant): The proposed study represents the first test of a savings-led microfinance intervention combined with HIV prevention on reductions of sexual risk behaviors among female sex workers (FSWs). The study may advance the gender-specific prevention repertoire for women who are at risk for HIV and STIs globally. More specifically, the US/Mongolian collaborative research team will: (1) integrate social cognitive and asset theories in the development and implementation of a microfinance intervention that will promote women's HIV risk reduction and economic self-sufficiency; (2) test a combination of multiple evidence-based microfinance components (financial literacy, business development training/mentorship, and matched savings), which are derived from asset theory, to promote HIV risk reduction and economic self sufficiency; (3) test a microfinance model that is sensitive to the unique needs of FSWs by (a) providing substantial training for personal financial literacy and business management [which most microfinance institutions do not provide]; (b) teaching women about the risks of credit before referring to loan programs; and (c) providing matched savings to build assets towards business development; and (4) test for the first time whether microfinance with a matched savings component can impact reductions in sexual risk among sex workers in a low income country. We will randomly assign 134 FSWs meeting eligibility criteria and completing a baseline assessment to either an evidence-based HIV sexual risk reduction intervention (HIVSRR) plus microfinance (HIVSRR+MF) or to the HIVSRR alone as a control condition, conducting follow-up assessments at immediate post test, 3 and 6 months post intervention. Evidence suggests that such combination of microfinance and HIV prevention may have a greater potential for risk reduction among women who-- because of their reliance on sexual behavior as a means of economic support-- have a compromised ability to be concerned with longer term health consequences such as HIV or sexually transmitted infections (STIs). This study responds to the identified need in the literature for rigorous testing of combination microfinance and HIV prevention in support of sexual risk reduction among women where individually based interventions are too limited, and gender, economic and migration issues restrict the impact of existing prevention intervention strategies. PUBLIC HEALTH RELEVANCE: The proposed study represents the first test of a savings-led microfinance intervention combined with HIV prevention on reductions of sexual risk behaviors among female sex workers (FSWs). We will randomly assign 134 FSWs meeting eligibility criteria and completing a baseline assessment to either an evidence-based HIV sexual risk reduction intervention (HIVSRR) plus microfinance (HIVSRR+MF) or to the HIVSRR alone as a control condition, conducting follow up assessment at immediate post test, 3 and 6 months post intervention.