Piloting a Savings-Led Microfinance Intervention with Women Engaging in Sex Work in Mongolia: Further Innovation for HIV Risk Reduction

Abstract

This paper describes a pilot study testing the feasibility of an innovative savings-led microfinance intervention in increasing the economic empowerment and reducing the sexual risk behavior of women engaging in sex work in Mongolia. Women’s economic vulnerability may increase their risk for HIV by compromising their ability to negotiate safer sex with partners and heightening the likelihood they will exchange sex for survival. Microfinance has been considered a potentially powerful structural HIV prevention strategy with women conducting sex work, as diversification of income sources may increase women’s capacity to negotiate safer transactional sex. With 50% of all reported female HIV cases in Mongolia detected among women engaging in sex work, direct prevention intervention with women conducting sex work represents an opportunity to prevent a potentially rapid increase in HIV infection in urban Mongolia. The piloted intervention consisted of a matched savings program in which matched savings could be used for business development or vocational education, combined with financial literacy and business development training for women engaging in sex work. Results of the pilot demonstrate participants’ increased confidence in their ability to manage finances, greater hope for pursuing vocational goals, moderate knowledge gains regarding financial literacy, and an initial transition from sex work to alternative income generation for five out of nine participants. The pilot findings highlight the potential for such an intervention and the need for a clinical trial testing the efficacy of savings-led microfinance programs in reducing HIV risk for women engaging in sex work in Mongolia.

Acceptability of a microfinance‐based empowerment intervention for transgender and cisgender women sex workers in Greater Kuala Lumpur, Malaysia

“…Moreover, many participants lacked capital to initiate a small business. These particular barriers could be ameliorated through reimbursing potential beneficiaries for time spent in training sessions [ 23 ] and offering micro-credits upon completion of the course [ 18 , 22 ].…”

“…Microfinance interventions targeting CWSWs have shown promise in empowering participants to develop additional sources of income [ 19 , 21 – 23 ] and reducing sexual risk behaviours; in one such intervention in Nairobi, two-thirds of participants reported having an operational small business by the end of the intervention [ 27 ]. In the Undarga programme, which combined vocational education with financial literacy and HIV prevention training for CWSWs in Ulaanbaatar (Mongolia) [ 22 ], beneficiaries reported having fewer paying sexual partners and were less likely to engage in unprotected sex with clients [ 21 ].…”

The Impact of Violence, Perceived Stigma, and Other Work-Related Stressors on Depressive Symptoms Among Women Engaged in Sex Work

“…However, no studies exist on the mental health of women in sex work in Mongolia. Although the practice of prostitution is illegal in Mongolia, a lack of economic opportunities has led to certain sectors of the population to engage in sex work as a primary source of income (World Bank, 2013, Tsai et al, 2011). Mongolia’s rapid transition to a capitalist economy in the 1990s and the subsequent global economic crises in 2008 resulted in a lack of employment opportunities that disproportionately affected women.…”

“…Mongolia’s rapid transition to a capitalist economy in the 1990s and the subsequent global economic crises in 2008 resulted in a lack of employment opportunities that disproportionately affected women. Despite being highly educated, the majority of women engaging in sex work do so as a result of financial difficulties or family financial crises, unable to find other kinds of employment (Tsai et al, 2011). …”

The impact of a microsavings intervention on reducing violence against women engaged in sex work: a randomized controlled study

“…The treatment condition, which was based on social cognitive and asset theories, consisted of the aforementioned 4-session HIVSRR intervention plus a microsavings intervention, which was successfully piloted with promising results prior to study implementation [31]. Fundamental to Social Cognitive Theory (SCT) is the concept of self-efficacy, which impacts whether people consider changing their behavior, the level of effort they invest in behavioral change, and long-term maintenance of behavior change [32, 33].…”