Marseille 2007
| Abstract #273 - Integrating Microfinance Programs and HIV/AIDS Prevention: Global Debates, Needs, and Evidence | ||||
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Session: 19.1: Universal Access to care (Parallel) on Monday @ 14.00-16.00 in HC Chaired by Shirin Heidari, Jean-Paul Moatti Authors: Presenting Author: Dr Shari Dworkin - Columbia University and NYSPI, United States |
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| Additional Authors: Dr Anke Ehrhardt, | ||||
| Aim: Researchers argue that poverty and gender inequality exacerbate the spread of HIV/AIDS and that economic empowerment can therefore assist in the prevention and mitigation of the disease, particularly for women. However, few researchers have developed interventions that merge economic programs with HIV/AIDS prevention. This issues-based paper examines the promise and limits of an integration between HIV/AIDS prevention and microfinance programs. First, we assess the need for integration between HIV/AIDS prevention and economic interventions. Second, given claims that microfinance leads to “empowerment” for women, we critically evaluate the evidence concerning the effect that microfinance programs have on specific indicators of women’s empowerment. Third, we consider the extent to which the benefits that result from participation in microfinance have direct relevance for HIV/AIDS risk reduction efforts. Finally, we consider remaining research questions and future research agendas that will help to rigorously assess the HIV/AIDS risk reduction benefits of microfinance programs. | ||||
| Method / Issue: We draw from all published literature globally in gender and development, reproductive health, and HIV/AIDS prevention to critically examine how microfinance participation shapes indicators of “women’s empowerment.” We examine the impact of economic programs on six different empowerment indicators, including: economic impact, intrahousehold decision-making, reproductive health negotiating power, mobility and ascribed public status, the ability to keep children in school, and domestic violence. Main findings include (1) Results showed improved decision-making power in the areas of household purchases, keeping children in school, and making decisions related to contraceptive use and fertility. (2) Women’s ability to make increased economic contributions to the household may provide a base of power from which to improve negotiations with male partners in other areas, including health. (3) The question as to whether increased economic power also forms a basis from to improve sexual relationship power or safer sex negotiations is an important issue, and as of yet unexplored. | ||||
| Results / Comments: Future research is sorely needed at the intersection of microfinance and HIV/AIDS prevention. Despite the need for randomized trials in the future that can test the efficacy of an integrated HIV/MF program, much groundwork is still needed to get to this ultimate endpoint. Currently, we truly do not have empirical tests that examine which program components may matter most for economic or sexual empowerment outcomes. There is therefore a clear research need at the institutional level to examine whether certain types of MF program components (such as those that assist women in the control of the loan, assist with overcoming gendered barriers to business success, or are flexible in product offerings) help to maximize women’s economic or sexual empowerment. Comparative case studies are clearly needed at the institutional level in order to examine whether microfinance programs with various different missions and emphases such as “community poverty reduction” “feminist empowerment” or “financial sustainability” might differentially affect HIV/AIDS risk reduction outcomes. We also do not know the precise mechanisms through which increased income works to improve decision-making power. Clear theoretical models and operationalizations that specify the relationship between economic power, increased agency, and safer sex negotiating power are needed. | ||||
| Discussion: Clearly, much work needs to be done in the area of integrating MF, gender equity, and HIV/AIDS prevention. Millions of poor women around the world have already been reached through economic initiatives and millions more could feasibly be reached for prevention purposes. The need for research that centers on the integration of microfinance and HIV/AIDS is clear given the global urgency to achieve reductions in poverty, improvements in HIV/AIDS prevention, and minimize the impact of HIV/AIDS. It is likely that such integrations will be increasingly sought out by both the poverty-reduction and HIV/AIDS arenas. This trend should not be surprising given that the United Nations Millennium Development Goals have firmed up the tripartite commitment to improve women’s empowerment, decrease poverty, and fight HIV/AIDS. It is our hope that our critical considerations and suggested future research plans will better equip the next generation of prevention researchers who seek to simultaneously target women’s economic and sexual empowerment. | ||||
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