Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 1/2019

01-01-2019 | Original Paper

Project Nova: A Combination HIV Prevention and Microfinance Intervention for Women Who Engage in Sex Work and Use Drugs in Kazakhstan

Authors: Gaukhar Mergenova, Nabila El-Bassel, Tara McCrimmon, Assel Terlikbayeva, Sholpan Primbetova, Marion Riedel, Azamat Kuskulov, Carolina Velez-Grau, Susan S. Witte

Published in: AIDS and Behavior | Issue 1/2019

Login to get access

Abstract

Innovative combination HIV-prevention and microfinance interventions are needed to address the high incidence of HIV and other STIs among women who use drugs. Project Nova is a cluster-randomized, controlled trial for drug-using female sex workers in two cities in Kazakhstan. The intervention was adapted from prior interventions for women at high risk for HIV and tailored to meet the needs of female sex workers who use injection or noninjection drugs. We describe the development and implementation of the Nova intervention and detail its components: HIV-risk reduction, financial-literacy training, vocational training, and a matched-savings program. We discuss session-attendance rates, barriers to engagement, challenges that arose during the sessions, and the solutions implemented. Our findings show that it is feasible to implement a combination HIV-prevention and microfinance intervention with highly vulnerable women such as these, and to address implementation challenges successfully.
Literature
1.
Ministry of Healthcare of the Republic of Kazakhstan. Population size estimate of people who inject drugs (PWID) in the Republic of Kazakhstan. Almaty: Republican Center on Prevention and Control of AIDS; 2016.
2.
Ministry of Healthcare of the Republic of Kazakhstan. National report on the AIDS response. Almaty: Republican Center on Prevention and Control of AIDS; 2016.
3.
UNAIDS. UNAIDS report on the global AIDS epidemic. Geneva: Joint United Nations Programme on HIV/AIDS; 2010.
4.
UNAIDS. Global report: UNAIDS report on the global AIDS epidemic. Geneva: UNAIDS; 2013.
5.
Baral S, Beyrer C, Muessig K, et al. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(7):538–49.CrossRef
6.
Baral S, Todd CS, Aumakhan B, Lloyd J, Delegchoimbol A, Sabin K. HIV among female sex workers in the Central Asian Republics, Afghanistan, and Mongolia: contexts and convergence with drug use. Drug Alcohol Depend. 2013;132:S13–6.CrossRef
7.
Pinkham S, Malinowska-Sempruch K. Women, harm reduction and HIV. Rep Health Matters. 2008;16(31):168–81.CrossRef
8.
Stratford D, Mizuno Y, Williams K, Courtenay-Quirk C, O’Leary A. Addressing poverty as risk for disease: recommendations from CDC’s consultation on microenterprise as HIV prevention. Public Health Rep. 2008;123(1):9.CrossRef
9.
Shannon K, Kerr T, Allinott S, Chettiar J, Shoveller J, Tyndall MW. Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work. Soc Sci Med. 2008;66:911–21.CrossRef
10.
El-Bassel N, Terlikbaeva A, Pinkham S. HIV and women who use drugs: double neglect, double risk. Lancet. 2010;376(9738):312–4.CrossRef
11.
Rhodes T, Wagner K, Strathdee SA, Shannon K, Davidson P, Bourgois P. Structural violence and structural vulnerability within the risk environment: theoretical and methodological perspectives for a social epidemiology of HIV risk among injection drug users and sex workers. In: Rethinking Soc Epidemiology. Dordrecht: Springer; 2012. P. 205–230.
12.
Blankenship KM, Koester S. Criminal law, policing policy, and HIV risk in female street sex workers and injection drug users. J Law Med Ethics. 2002;30(4):548–59.CrossRef
13.
Wechsberg WM, Krupitsky E, Romanova T, et al. Double jeopardy—drug and sex risks among Russian women who inject drugs: initial feasibility and efficacy results of a small randomized controlled trial. Subst Abuse Treat Pr. 2012;7(1):1.CrossRef
14.
El-Bassel N, Strathdee SA, El Sadr WM. HIV and people who use drugs in central Asia: confronting the perfect storm. Drug Alcohol Depend. 2013;132(1):S2–6.CrossRef
15.
Dworkin SL, Blankenship K. Microfinance and HIV/AIDS prevention: assessing its promise and limitations. AIDS Behav. 2009;13(3):462–9.CrossRef
16.
Kennedy CE, Fonner VA, O’Reilly KR, Sweat MD. A systematic review of income generation interventions, including microfinance and vocational skills training, for HIV prevention. AIDS Care. 2014;26(6):659–73.CrossRef
17.
Arrivillaga M, Salcedo JP. A systematic review of microfinance-based interventions for HIV/AIDS prevention. AIDS Educ Prev. 2014;26(1):13–27.CrossRef
18.
Cui RR, Lee R, Thirumurthy H, Muessig KE, Tucker JD. Microenterprise development interventions for sexual risk reduction: a systematic review. AIDS Behav. 2013;17(9):2864–77.CrossRef
19.
Pronyk PM, Kim JC, Abramsky T, et al. A combined microfinance and training intervention can reduce HIV risk behavior in young female participants. AIDS. 2008;22:1659–65.CrossRef
20.
Witte SS, Aira T, Tsai LC, et al. Efficacy of a savings-led microfinance intervention to reduce sexual risk for HIV among women engaged in sex work: a randomized clinical trial. Am J Public Health. 2015;105(3):e95–102.CrossRef
21.
Sherman SG, German D, Cheng Y, Marks M, Bailey-Kloche M. The evaluation of the JEWEL project: an innovative economic enhancement and HIV prevention intervention study targeting drug using women involved in prostitution. AIDS Care. 2006;18(1):1–11.CrossRef
22.
Sherman SG, Srikrishnan AK, Rivett KA, Liu SH, Solomon S, Celentano DD. Acceptability of a microenterprise intervention among female sex workers in Chennai, India. AIDS Behav. 2010;14(3):649–57.CrossRef
23.
Frantz D. Drug use begetting AIDS in Central Asia. New York Times. August 5, 2001.
24.
Buzurukov A. HIV/AIDS epidemic: time is running out for Central Asia. Central Asia/Caucasus Analyst. 2002.
25.
McCrimmon T, Witte S, Mergenova G, et al. Microfinance for women at high risk for HIV in Kazakhstan: study protocol for a cluster-randomized controlled trial. BMC Trials. 2008;19(1):187.CrossRef
26.
Bandura A. Social foundations of thought and action: a social and cognitive theory. Englewood Cliffs, NJ: Prentice-Hall; 1986.
27.
Bandura A. Self-efficacy: the exercise of control. New York: W. H. Freeman; 1997.
28.
Marlatt GA, Witkiewitz K. Update on harm-reduction policy and intervention research. Annu Rev Clin Psychol. 2010;6(1):591–606.CrossRef
29.
Ti L, Kerr T. The impact of harm reduction on HIV and illicit drug use. Harm Reduct J. 2014;11(1):7.CrossRef
30.
Sherraden M. Stakeholding: notes on a theory of welfare based on assets. Soc Ser Rev. 1990;64(4):580–601.CrossRef
31.
Sherraden M. Assets and the poor: a new American welfare policy. New York: M. E. Sharpe; 1991.
32.
Oosterhoff P, Nguyen T, Pham N, Wright P, Hardon A. Can micro-credit empower HIV + women? An exploratory case study in Northern Vietnam. Womens Health Urban Life. 2008;7(1):40–55.
33.
Amin R, Becker S. NGO-promoted microcredit programs and women’s empowerment in rural Bangladesh: quantitative and qualitative evidence. J Dev Areas. 1998;32(2):221–36.PubMed
34.
Ssewamala F, Sherraden M. Integrating saving into microenterprise programs for the poor: do institutions matter? Soc Ser Rev. 2004;78(3):404–29.CrossRef
35.
Ssewamala FM, Chang-Keun H, Neilands T, Ismayilova L, Sperber E. The effect of economic assets on sexual risk taking intentions among orphaned adolescents in Uganda. Am J Public Health Rep. 2010;100(3):483–9.CrossRef
36.
Ssewamala FM, Chang-Keun H, Neilands T. Asset ownership and health and mental health functioning among AIDS-orphaned adolescents: findings from a randomized clinical trial in rural Uganda. Soc Sci Med. 2009;69(2):191–8.CrossRef
37.
Ssewamala FM, Alicea S, Bannon W, Ismayilova L. A novel economic intervention to reduce HIV risks among school-going AIDS-orphaned children in rural Uganda. J Adolesc Health. 2008;42(1):102–4.CrossRef
38.
Odek WO, Busza J, Morris CN, Cleland J, Ngugi EN, Ferguson AG. Effects of micro-enterprise services on HIV risk behavior among female sex workers in Kenya’s urban slums. AIDS Behav. 2009;13:449–61.CrossRef
39.
Karlan D, Valdivia M. Teaching entrepreneurship: impact of business training on microfinance clients and institutions. Rev Econ Stat. 2011;93(2):510–27.CrossRef
40.
El-Bassel N, Gilbert L, Goddard-Eckrich D, et al. Efficacy of a group-based multimedia HIV prevention intervention for drug-involved women under community supervision: project worth. PLoS ONE. 2014;9(11):e111528.CrossRef
41.
El-Bassel N, Gilbert L, Terlikbayeva A, et al. Effects of a couple-based intervention to reduce risks for HIV, HCV, and STIs among drug-involved heterosexual couples in Kazakhstan: a randomized controlled trial. J Acquir Immune Defic Syndr. 2014;67(2):196–203.CrossRef
42.
Opportunities Microfinance. Global financial education program. Washington, DC: Microfinance Opportunities; 2002.
43.
Tsai LC, Witte SS, Aira T, Riedel M, Offringa R, Chang M. Efficacy of a microsavings intervention in increasing income and reducing economic dependence upon sex work among women in Mongolia. Int Soc Work. 2015;61(1):6–22.CrossRef
44.
El-Bassel N, Jemmott JB, Landis JR, et al. National Institute of Mental Health multisite Eban HIV/STD prevention intervention for African American HIV serodiscordant couples: a cluster randomized trial. Arch Intern Med. 2010;170(17):1594–601.CrossRef
45.
El-Bassel N, Witte SS, Gilbert L, et al. The efficacy of a relationship-based HIV/STD prevention program for heterosexual couples. Am J Public Health. 2003;93(6):963–9.CrossRef
46.
World Bank. Global economic prospects: weak investments in uncertain times. Washington, DC: International Bank for Reconstruction and Development/World Bank; 2017.
47.
WHO, UNFPA, UNAIDS, NSWP, Bank W, UNDP. Implementing comprehensive HIV/STI programmes with sex workers: practical approaches from collaborative interventions. Geneva: World Health Organization; 2013.
48.
Network of Sex Work Projects. Policy brief: impact of criminalization of sex workers’ vulnerability to HIV and violence; 2017.
49.
El-Bassel N, Gilbert L, Witte S, Wu E, Chang M. Intimate partner violence and HIV among drug-involved women: contexts linking these two epidemics—challenges and implications for prevention and treatment. Subst Use Misuse. 2011;46(2–3):295–306.CrossRef
50.
Weaver TL, Gilbert L, El-Bassel N, Resnick HS, Noursi S. Identifying and intervening with substance-using women exposed to intimate partner violence: phenomenology, comorbidities, and integrated approaches within primary care and other agency settings. J Women’s Health. 2015;24(1):51–6.CrossRef
Metadata
Title
Project Nova: A Combination HIV Prevention and Microfinance Intervention for Women Who Engage in Sex Work and Use Drugs in Kazakhstan
Authors
Gaukhar Mergenova
Nabila El-Bassel
Tara McCrimmon
Assel Terlikbayeva
Sholpan Primbetova
Marion Riedel
Azamat Kuskulov
Carolina Velez-Grau
Susan S. Witte
Publication date
01-01-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue 1/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-018-2268-1

Other articles of this Issue 1/2019

AIDS and Behavior 1/2019 Go to the issue

Commentary

Composite Risk for HIV: A New Approach Towards Integrating Biomedical and Behavioral Strategies in Couples-Based HIV Prevention Research

Original Paper

Causal Effects of Alcohol Intoxication on Sexual Risk Intentions and Condom Negotiation Skills Among High-Risk Men Who Have Sex with Men (MSM)

Original Paper

An Investigation of Racial and Ethnic Homophily on Grindr Among an Ongoing Cohort Study of YMSM

Original Paper

A Randomized Controlled Pilot Study of a Culturally-Tailored Counseling Intervention to Increase Uptake of HIV Pre-exposure Prophylaxis Among Young Black Men Who Have Sex with Men in Washington, DC

Original Paper

Fecal Coliform Bacterial Detection to Assess Enema Adherence in HIV Prevention Clinical Studies

Original Paper

Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits