Evaluating a Microfinance Intervention for High Risk Women in Mongolia

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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.