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Mobilising Social Capital in a World with AIDS

Mobilising Social Capital in a World with AIDS. AIDS2031 Conference 30 March to April 1, 2009 Salzburg, Austria. Effects of micro-enterprise services on HIV risk behaviour among female sex workers in Kenya's urban slums . Willis Odek Doctoral Student University of Aberdeen, UK. Background .

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Mobilising Social Capital in a World with AIDS

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  1. Mobilising Social Capital in a World with AIDS AIDS2031 Conference 30 March to April 1, 2009 Salzburg, Austria

  2. Effects of micro-enterprise services on HIV risk behaviour among female sex workers in Kenya's urban slums Willis Odek Doctoral Student University of Aberdeen, UK

  3. Background Gender (regular partnerships) Individual-focused targeted intervention among FSWs • Peer STI/HIV/AIDS education • Condom promotion Risk/vulnerability reduction outcomes Economic deprivation Fear of health services

  4. Intervention strategies • STI/HIV/AIDS Education • Safer sex negotiation • STI counselling • Proper & consistent condom use (in both vaginal and anal sex) • Reduction of number of partners • Increased use of non-penetrative sex • Sex avoidance in menses • Health provider training • STI counselling • STI syndromic management • Referrals – STI/HIV care and support Micro-enterprise support services • Credit finance • Business training • Savings • Control • Self-esteem • Assertiveness • Increase or stabilise income • Social capital –credit groups, education & training

  5. Methods • Pre-post survey of sexual behaviour among 227 FSWs (18-23 months) • Condom use • Number of sexual partners • Continued involvement in sex work

  6. Findings – participant characteristics • Generally older – mean age 41 years • Average 4 dependents • Education – illiterate (17.3%); primary (55.1%); and secondary (27.6%). • Majority have ever been married – 62.6%.

  7. Main outcomes • Business survival – 65% • Substantial self-reported exit from sex work – (45.4%) • Significant reductions in regular partnerships (mean 1.96 B/L to 0.73 E/L); average 1 casual partner. • Sustained consistent condom use with casual partners (>90%) and ≈20% improvement within regular partnerships

  8. Main outcomes contd. • Business operational status or loan amount received not significantly correlated with sexual behaviour change

  9. Key messages • Microfinance for micro-enterprise economic activities appears more appropriate for older women seeking to exit sex work; • Younger women (at peak age of HIV vulnerability 15-24 years) may require a different economic empowerment strategy.

  10. Making a difference by 2031 • Promote formal education for girls emphasising progression beyond basic to secondary and tertiary education • Continue targeted interventions (HIV and livelihoods) among marginalised women emphasising greater integration with society • Move economic support programmes from petty commerce to skills-based, better-paying enterprises for young and older women • Strengthen programmes for youth employment both nationally and regionally

  11. Acknowledgements • University of Nairobi • University of Manitoba • Programme participants • Wellcome Trust, UK • London School of Hygiene and Tropical Medicine

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