17th International AIDS Conference Mexico City, Mexico - August 13 - 18, 2008

A COMBINED MICROFINANCE AND TRAINING INTERVENTION CAN REDUCE HIV RISK BEHAVIOUR AMONG YOUNG PROGRAM PARTICIPANTS: RESULTS FROM THE IMAGE STUDY

Int Conf AIDS. 2008 Aug 13-18;17 Abstract No. MoAc0201

P. Pronyk¹, J. Kim¹, T. Abramsky², G. Phetla¹, J. Hargreaves², L. Morison², C. Watts ², J. Busza², J. Porter²

BACKGROUND: The IMAGE (Intervention with Microfinance for AIDS and Gender Equity) cluster-randomized trial evaluated a structural intervention combining microfinance with gender/HIV training. Primary trial results reported improvements in economic well-being, women’s empowerment, and a 55% reduction in intimate partner violence. Direct effects on HIV risk were not initially analysed as microfinance participants (median age 42 years) were generally outside the high-risk age group. We present secondary analysis of quantitative and qualitative data from the IMAGE study examining changes in HIV risk behaviour among young programme participants.

METHODS: Eight villages were pair-matched and randomly allocated to receive the intervention. At baseline and after two years, female participants aged 14-35 years old (31% of all participants) were asked questions about HIV risk behaviours. Responses were compared to women from the same age and poverty group from control villages. Intervention effects were calculated at the cluster level, using adjusted risk ratios employing village level summaries. Qualitative data collected during the study explored participants’ responses to the intervention including HIV risk behaviour.

RESULTS: After 2 years, young intervention participants had higher levels of HIV-related communication (aRR 1.46 95% CI 1.01-2.12), were more likely to have accessed voluntary counseling and testing (aRR 1.64 95% CI 1.06- 2.56), and less likely to have had unprotected sex at last intercourse with a non-spousal partner (aRR 0.76 95% CI 0.60-0.96). Qualitative data suggest a greater acceptance of intra-household communication about previously sensitive issues of HIV and sexuality. While women noted challenges associated with male acceptance of condoms, increased confidence and skills associated with participation in the intervention supported their effective introduction in sexual relationships.

CONCLUSIONS: In addition to impacts on economic well-being, women’s empowerment and intimate partner violence, interventions addressing the economic and social vulnerability of women may also contribute to reductions in high-risk sexual behaviour among young program participants.

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2008-08-13
MoAc0201

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