title: A combined microfinance and training intervention can reduce HIV risk behaviour in young female participants.
abstract: OBJECTIVE
  To assess effects of a combined microfinance and training intervention on HIV risk behavior among young female participants in rural South Africa.
  
  
  METHODS
  : Secondary analysis of quantitative and qualitative data from a cluster randomized trial, the Intervention with Microfinance for AIDS and Gender Equity study.
  
  
  METHODS
  Eight villages were pair-matched and randomly allocated to receive the intervention. At baseline and after 2 years, HIV risk behavior was assessed among female participants aged 14-35 years. Their responses were compared with women of the same age and poverty group from control villages. Intervention effects were calculated using adjusted risk ratios employing village level summaries. Qualitative data collected during the study explored participants' responses to the intervention including HIV risk behavior.
  
  
  RESULTS
  After 2 years of follow-up, when compared with controls, young participants had higher levels of HIV-related communication (adjusted risk ratio 1.46, 95% confidence interval 1.01-2.12), were more likely to have accessed voluntary counseling and testing (adjusted risk ratio 1.64, 95% confidence interval 1.06-2.56), and less likely to have had unprotected sex at last intercourse with a nonspousal partner (adjusted risk ratio 0.76, 95% confidence interval 0.60-0.96). Qualitative data suggest a greater acceptance of intrahousehold communication about HIV and sexuality. Although women noted challenges associated with acceptance of condoms by men, increased confidence and skills associated with participation in the intervention supported their 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 contribute to reductions in HIV risk behavior.
authors.affiliation: Rural AIDS & Development Action Research Program, School of Public Health, University of Witwatersrand, Johannesburg, South Africa. pronyk@agincourt.co.za
authors.forename: Paul M
authors.initials: PM
authors.lastname: Pronyk
authors.forename: Julia C
authors.initials: JC
authors.lastname: Kim
authors.forename: Tanya
authors.initials: T
authors.lastname: Abramsky
authors.forename: Godfrey
authors.initials: G
authors.lastname: Phetla
authors.forename: James R
authors.initials: JR
authors.lastname: Hargreaves
authors.forename: Linda A
authors.initials: LA
authors.lastname: Morison
authors.forename: Charlotte
authors.initials: C
authors.lastname: Watts
authors.forename: Joanna
authors.initials: J
authors.lastname: Busza
authors.forename: John Dh
authors.initials: JD
authors.lastname: Porter
mesh_terms: D000293:Adolescent; D000328:Adult; D004467:Economics; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D011203:Poverty; D040242:Risk Reduction Behavior; D012424:Rural Population; D013019:South Africa; D014933:Women's Rights / Q000191:economics*