Evaluating a Microfinance Intervention for High Risk Women in Mongolia

描述(由申请人提供)：这项拟议的研究是对储蓄主导的小额信贷干预与艾滋病毒预防相结合的减少女性性工作者(FSWs)性行为风险行为的首次测试。这项研究可能会在全球范围内推进针对艾滋病毒和性传播感染风险女性的特定性别预防体系。更具体地说，美国/蒙古合作研究小组将：(1)在开发和实施小额信贷干预措施时整合社会认知和资产理论，以促进妇女艾滋病毒风险降低和经济自给自足；(2)测试源自资产理论的多种循证小额信贷组成部分(金融知识、商业发展培训/指导和匹配储蓄)的组合，以促进艾滋病毒风险降低和经济自给自足；(3)测试对妇女服务工作者的独特需求敏感的小额信贷模式，方法是：(A)为个人金融知识和企业管理提供实质性培训[大多数小额信贷机构没有提供]；(B)在提到贷款方案之前，向妇女传授信贷风险；(C)提供相匹配的储蓄，以建立用于商业发展的资产；以及(4)首次测试具有相匹配的储蓄部分的小额信贷是否能够影响低收入国家性工作者的性风险的降低。我们将随机将134名符合资格标准并完成基线评估的暗娼随机分配到循证HIV性风险降低干预(HIVSRR)+小额信贷(HIVSRR+MF)或单独接受HIVSRR作为对照条件，在测试后立即、干预后3个月和6个月进行跟踪评估。有证据表明，小额信贷和艾滋病毒预防的这种结合可能在妇女中具有更大的降低风险的潜力，因为她们依赖性行为作为一种经济支持手段，担心艾滋病毒或性传播感染等长期健康后果的能力受到损害。这项研究回应了文献中确定的严格测试小额供资和艾滋病毒预防相结合的需要，以支持降低妇女的性风险，其中基于个人的干预措施过于有限，性别、经济和移徙问题限制了现有预防干预战略的影响。 公共卫生相关性：这项拟议的研究是对储蓄主导的小额信贷干预与艾滋病毒预防相结合的减少女性性工作者(FSWs)性行为风险行为的首次测试。我们将随机将134名符合资格标准并完成基线评估的暗娼随机分配到循证HIV性风险降低干预(HIVSRR)+小额信贷(HIVSRR+MF)或单独接受HIVSRR作为对照条件，在干预后立即、干预后3个月和6个月进行跟踪评估。

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.