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毒预防相结合，减少女性性工作者（FSW）的性风险行为的第一次测试。这项研究可能会推动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/蒙古合作研究小组将：（1）将社会认知和资产理论纳入小额信贷干预措施的制定和实施，以促进妇女减少艾滋病毒风险和经济自给自足;（2）测试多个循证小额信贷组成部分的组合（金融知识、商业发展培训/指导和匹配储蓄），以促进减少艾滋病毒风险和经济自给自足;（3）测试一种对FSW的独特需求敏感的小额信贷模式，具体做法是：（a）提供个人金融知识和商业管理方面的实质性培训[大多数小额信贷机构不提供这种培训];（B）在向妇女介绍贷款方案之前，向她们介绍信贷的风险;以及（c）提供匹配储蓄，为企业发展积累资产;以及（4）首次测试具有匹配储蓄组成部分的小额信贷是否能够影响降低低收入国家性工作者的性风险。我们将134名符合资格标准并完成基线评估的FSW随机分配到以证据为基础的HIV性风险降低干预（HIVSRR）+小额信贷（HIVSRR+MF）或仅HIVSRR作为对照条件，在测试后立即进行随访评估，干预后3个月和6个月。有证据表明，小额供资和艾滋病毒预防的这种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持的手段，因此对艾滋病毒或性传播感染等长期健康后果的关注能力受到损害。这项研究回应了文献中确定的需要，即对小额信贷和艾滋病毒预防相结合进行严格测试，以支持减少妇女的性风险，因为基于个人的干预措施太有限，性别、经济和移民问题限制了现有预防干预战略的影响。 公共卫生相关性：这项拟议的研究代表了储蓄主导的小额信贷干预与艾滋病毒预防相结合，减少女性性工作者（FSW）性风险行为的第一次测试。我们将134名符合资格标准并完成基线评估的FSW随机分配到以证据为基础的HIV性风险降低干预（HIVSRR）+小额信贷（HIVSRR+MF）或仅HIVSRR作为对照条件，在测试后立即进行随访评估，干预后3个月和6个月。

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.