ESTIMA: Empowerment of Sex workers To Increase Social and Economic Mobility

ESTIMA：赋予性工作者权力以增加社会和经济流动性

• 批准号: 9259689
• 负责人: Elizabeth Ann Reed
• 金额: $ 18.02万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9259689
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Adverse event; Affect; Border Crossings; Businesses; Capital; Child; Cities; Client; Communities; Control Groups; Data; Dependence; Drug usage; Economic Conditions; Economic Development; Economics; Ensure; Ethics; Evaluation; Evaluation Methodology; Family; Feedback; Focus Groups; Future; Gender; Goals; HIV; HIV risk; HIV/STD; Health; Incidence; Income; International; Intervention; Interview; Latin America; Life; Link; Measurement; Measures; Mediation; Methodology; Mexican; Mexico; Monitor; Needles; Outcome; Participant; Pharmaceutical Preparations; Police; Poverty; Prevalence; Prevention program; Program Appropriateness; Randomized; Recording of previous events; Recruitment Activity; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Security; Social Power; South Africa; Structure; Testing; Time; Training; Translating; Unsafe Sex; Waiting Lists; Woman; Work; arm; condoms; design; economic indicator; empowerment; experience; female sex worker; follow-up; gender equity; gender-based violence; male; programs; satisfaction; sex; sexual violence; skills; social; therapy design

DESCRIPTION (provided by applicant): Given the increasing recognition of the contribution of structural-level factors (e.g. gendered economic and social power imbalances) on both HIV and gender-based violence (GBV) among women, and thereby, the need for interventions that aim to alter such structures within communities, I have developed the proposed training to provide an opportunity for me to expand my work on the intersection of GBV and HIV by: 1) developing new skills related to structural-level interventions that specifically focus on economic promotion among women, and 2) enhancing my expertise related to the implementation and rigorous evaluation of structural interventions to address these issues. Notably, developing new skills and receiving training in methodologies (e.g. evaluation, measurement) related to structural-level interventions that specifically focus on economic promotion among women will provide me with a unique skill set possessed by only a handful of researchers in the field, particularly among researchers focusing on both GBV and HIV. The training aims will be accomplished through a combination of formal and/or informal coursework in economic development strategies and measures, structural interventions, and rigorous evaluation methodologies, as well as practical experience in the implementation and evaluation of a structural intervention. The proposed research aims to pilot a multi-strategy structural intervention combining community mobilization to promote gender equity alongside an economic intervention (microfinance and business training) in order to reduce gender-based violence and HIV risk among female sex workers (FSW) in Tijuana, Mexico. The program will be called ESTIMA: "Empowerment of Sex workers to Increase Social and Economic Mobility. The evaluation will employ a randomized controlled design, recruiting FSW (n=120, 60 in each arm) who will be randomized to: 1) ESTIMA (gender equity/community mobilization program and economic intervention) or 2) a wait-list control group. For this preliminary work, at 12 months follow-up, w hypothesize that compared to control participants, intervention participants will have: 1) significantly greater economic security (e.g. decreased debt, increased income, decreased number of sex trades) and 2) significantly greater perceived collective power (i.e. collective efficacy) to address gendered power imbalances within social structures and the community. The long-term goal of this program, upon future refinement and large scale implementation, is to reduce HIV risk behaviors, STI/HIV, GBV, and ultimately, alleviate a multitude of health burdens among women. Furthermore, we expect that such work will highlight the need for HIV prevention initiatives in Mexico, and elsewhere, to more broadly consider women's 'life contexts' - addressing economic and social burdens in women's lives, to reduce the burden of poverty, gender, and HIV, as well as the intersection of these among women.

描述（申请人提供）：鉴于人们越来越认识到结构层面因素的贡献（例如，性别经济和社会权力不平衡）对妇女中艾滋病毒和基于性别的暴力的影响，因此，需要采取干预措施，以改变社区内的这种结构，我制定了拟议的培训，为我提供了一个机会，通过以下方式扩大我在性别暴力和艾滋病毒交叉方面的工作：1）发展与结构性干预措施有关的新技能，特别侧重于促进妇女的经济发展，2）加强我与实施和严格评估结构性干预措施以解决这些问题有关的专业知识。值得注意的是，开发新技能和接受与结构层面干预措施（特别是妇女经济促进措施）相关的方法（例如评估，测量）培训，将为我提供该领域少数研究人员所拥有的独特技能，特别是专注于性别暴力和艾滋病毒的研究人员。培训目标将通过以下方式实现：经济发展战略和措施、结构性干预措施和严格的评价方法方面的正式和（或）非正式课程，以及在实施和评价结构性干预措施方面的实际经验。 拟议的研究旨在试行一项多战略结构性干预措施，将促进两性平等的社区动员与经济干预（小额信贷和商业培训）相结合，以减少墨西哥蒂华纳女性性工作者中基于性别的暴力和艾滋病毒风险。该计划将被称为ESTIMA：“赋予性工作者权力，以增加社会和经济流动性。评估将采用随机对照设计，招募FSW（n=120，每组60名），将其随机分配至：1）ESTIMA（性别平等/社区动员计划和经济干预）或2）等待名单对照组。对于这项初步工作，在12个月的随访中，我们假设与对照组参与者相比，干预组参与者将具有：1）显着更大的经济安全（例如债务减少，收入增加，性交易数量减少）和2）显着更大的感知集体力量（即集体效能），以解决社会结构和社区内的性别权力失衡。该方案的长期目标是，在今后进一步完善和大规模实施后，减少艾滋病毒风险行为、性传播感染/艾滋病毒、性别暴力，并最终减轻妇女的多种健康负担。此外，我们期望这项工作将突出墨西哥和其他地方的艾滋病毒预防倡议的必要性，以更广泛地考虑妇女的“生活背景”-解决妇女生活中的经济和社会负担，减轻贫困、性别和艾滋病毒的负担，以及这些问题在妇女中的交叉问题。