Evaluating a Microfinance Intervention for High Risk Women in Kazakhstan

评估对哈萨克斯坦高危妇女的小额信贷干预

基本信息

批准号：
9063497
负责人：
Nabila El-Bassel
金额：
$ 70.88万
依托单位：
COLUMBIA UNIV NEW YORK MORNINGSIDE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-07-01 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9063497
关键词：
Adult Anus Area Central Asia Characteristics Client Cognitive Cost Effectiveness Analysis Country Criminal Justice Data Drug usage Economics Employment Employment Status Enrollment Epidemic Female Gender Gonorrhea HIV HIV risk Health Health Status Hepatitis C Hepatitis C virus Heterosexuals High Risk Woman Incidence Income Infection Injecting drug user Injection of therapeutic agent Intervention Kazakhstan Lead Learning Legal Mediating Mediator of activation protein Mental Health Mongolia Outcome Outcome Study Participant Pharmaceutical Preparations Positioning Attribute Poverty Prevalence Prevention Prevention strategy Preventive Intervention Protocols documentation Public Health Randomized Randomized Controlled Trials Recording of previous events Reporting Research Risk Behaviors Risk Reduction Safety Savings Scientist Severities Sexual Partners Sexually Transmitted Diseases Site Substance abuse problem Syphilis Target Populations Testing Time Training Programs Trichomonas Vagina Virus Diseases Vocational Education Vulnerable Populations Woman Work acronyms arm base behavioral outcome cost cost effectiveness design efficacy trial experience female sex worker financial literacy follow-up injection drug use innovation intervention effect local economy male primary outcome programs secondary outcome sex skills social social cognitive theory social stigma theories transmission process viral transmission

项目摘要

DESCRIPTION (provided by applicant): The proposed study will examine the efficacy of a combined HIV and microfinance intervention to reduce biologically confirmed sexually transmitted infections (STIs), and new incidence of HIV and HCV, as well as reported sexual and drug risk behaviors among 520 women who have injected drugs in the past year and who engage in sex trading in Temirtau and Pavlodar, Kazakhstan. Kazakhstan is one of nine countries worldwide that has experienced a continuing rise in HIV infections (>25%) over the past decade. The epidemic is exacerbated by structural forces such as poverty and a lack of employment options for people who use drugs, especially women, which makes transactional sex a survival strategy. Recent calls for action by HIV prevention scientists have emphasized the need for innovative structural interventions for women engaged in sex work who are also drug-involved. The proposed study builds on findings from an R34 by the investigative team testing a combination HIV prevention and microfinance intervention. Building on successful protocols and significant results, we will randomly assign 520 women who inject drugs and engage in sex trading from Temirtau and Pavlodar, Kazakhstan to either (1) a 4 session HIV prevention intervention combined with a 6 session financial literacy intervention, enrollment in an existing vocational training program and receipt of matched savings (HIVRR+MF); or to the 4 session HIV prevention intervention alone. The HIVRR intervention is guided by social cognitive theory. The HIVRR+MF intervention integrates asset theory with social cognitive theory. The MF includes: 1) financial literacy; 2) vocational training; and 3) micro-savings to support transitionto a more permanent employment status. We hypothesize that increasing financial literacy, enhancing vocational skills required to fill marketable positions in the local economy, and beginning a personal savings program, combined with HIV risk reduction, will lead to significant reductions in study outcomes compared to an HIVRR intervention without a microfinance intervention. A qualitative component to examine factors that facilitate or impede women's ability to participate in and benefit from a microfinance intervention, and a cost and cost effectiveness analysis will provide additional data to inform a disseminable program if findings are significant. The findings from this study will be important not only for Central Asia, but may also have vital public health implications in the U.S. and other countries where HIV/STIs and HCV remain high and employment rates remain low among drug- involved women engaged in sex trading.

DESCRIPTION (provided by applicant): The proposed study will examine the efficacy of a combined HIV and microfinance intervention to reduce biologically confirmed sexually transmitted infections (STIs), and new incidence of HIV and HCV, as well as reported sexual and drug risk behaviors among 520 women who have injected drugs in the past year and who engage in sex trading in Temirtau and Pavlodar, Kazakhstan.哈萨克斯坦是全球九个国家之一，在过去的十年中，艾滋病毒感染持续增长（> 25％）。对于使用毒品，尤其是妇女的人（尤其是妇女）的结构性力量，使交易性别成为生存策略的人，诸如贫困和缺乏就业选择使这种流行病加剧了。艾滋病毒预防科学家采取行动的最新呼吁强调，需要对从事性工作的妇女进行创新的结构干预措施，这些妇女也有涉及毒品的性工作。拟议的研究基于调查小组的R34的发现，对艾滋病毒预防和小额信贷干预进行了测试。在成功的协议和重大结果的基础上，我们将随机分配520名女性注射毒品并从哈萨克斯坦的Temirtau和Pavlodar进行性交易，再到（1）（1）4次会议的HIV预防干预措施，并结合6次会议的财务素养干预，招募现有的职业培训计划，并接受了匹配的Savings Savings（Hivrr+MF）;或仅参加4届HIV预防干预措施。 HIVRR干预措施以社会认知理论为指导。 HIVRR+MF干预将资产理论与社会认知理论相结合。 MF包括：1）财务素养； 2）职业培训； 3）微观浪费，以支持过渡到更永久的就业状况。我们假设，提高金融素养，增强填补当地经济中可销售职位所需的职业技能，以及开始个人储蓄计划，加上降低HIV风险，将导致研究成果与HIVRR干预相比，而无需小额信贷干预。一个定性组成部分，用于研究促进或阻碍妇女参与和受益于小额信贷干预的能力以及成本和成本效益分析的能力，如果发现很大，则将提供其他数据，以告知可见计划。这项研究的发现不仅对中亚很重要，而且在美国和其他国家中的艾滋病毒/性传播疾病和HCV仍然很高，从事性交的毒品妇女中的就业率仍然很低，在美国和其他国家可能会产生至关重要的公共卫生影响。