title: Leveraging strong social ties among young men in Dar es Salaam: A pilot intervention of microfinance and peer leadership for HIV and gender-based violence prevention.
abstract: Gender inequality is at the core of the HIV patterns that are evident in sub-Saharan Africa. Gender-based violence (GBV) and lack of economic opportunity are important structural determinants of HIV risk. We piloted a microfinance and health promotion intervention among social networks of primarily young men in Dar es Salaam. Twenty-two individuals participated in the microfinance component and 30 peer leaders were recruited and trained in the peer health leadership component. We collected and analysed observational data from trainings, monitoring data on loan repayment, and reports of peer conversations to assess the feasibility and acceptability of the intervention. Eighteen of the loan recipients (82%) paid back their loans, and of these 15 (83%) received a second, larger loan. Among the loan defaulters, one died, one had chronic health problems, and two disappeared, one of whom was imprisoned for theft. The majority of conversations reported by peer health leaders focused on condoms, sexual partner selection, and HIV testing. Few peer leaders reported conversations about GBV. We demonstrated the feasibility and acceptability of this innovative HIV and GBV prevention intervention. The lessons learned from this pilot have informed the implementation of a cluster-randomised trial of the microfinance and peer health leadership intervention.
authors.affiliation: a Department of Health Behavior , The University of North Carolina at Chapel Hill, Gillings School of Global Public Health , Chapel Hill , NC , USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Maman
authors.affiliation: b Department of Psychiatry and Mental Health , Muhimbili University of Health and Allied Sciences , Dar es Salaam , Tanzania.
authors.forename: Lusajo
authors.initials: L
authors.lastname: Kajula
authors.affiliation: a Department of Health Behavior , The University of North Carolina at Chapel Hill, Gillings School of Global Public Health , Chapel Hill , NC , USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Balvanz
authors.affiliation: b Department of Psychiatry and Mental Health , Muhimbili University of Health and Allied Sciences , Dar es Salaam , Tanzania.
authors.forename: Mrema
authors.initials: M
authors.lastname: Kilonzo
authors.affiliation: a Department of Health Behavior , The University of North Carolina at Chapel Hill, Gillings School of Global Public Health , Chapel Hill , NC , USA.
authors.forename: Marta
authors.initials: M
authors.lastname: Mulawa
authors.affiliation: c School of International Service , American University , Washington , DC , USA.
authors.forename: Thespina
authors.initials: T
authors.lastname: Yamanis
mesh_terms: D015492:AIDS Serodiagnosis / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D005378:Financial Support; D000074386:Gender-Based Violence / Q000191:economics / Q000517:prevention & control*; D015658:HIV Infections / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control* / Q000635:transmission; D006266:Health Education / Q000191:economics / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D007857:Leadership; D008297:Male; D010379:Peer Group; D010865:Pilot Projects; D012725:Sexual Behavior / Q000706:statistics & numerical data; D058012:Small Business / Q000191:economics / Q000193:education* / Q000458:organization & administration; D012944:Social Support; D013636:Tanzania; D014933:Women's Rights / Q000592:standards / Q000639:trends; D055815:Young Adult
keywords: HIV; Tanzania; microfinance; violence; young men