Given the increasing recognition of the contribution of structural-level factors (e.g. gendered economic and social power imbalances) on both HIV and gender-based violence (GBV) among women, and thereby, the need for interventions that aim to alter such structures within communities, I have developed the proposed training to provide an opportunity for me to expand my work on the intersection of GBV and HIV by: 1) developing new skills related to structural-level interventions that specifically focus on economic promotion among women, and 2) enhancing my expertise related to the implementation and rigorous evaluation of structural interventions to address these issues. Notably, developing new skills and receiving training in methodologies (e.g. evaluation, measurement) related to structural-level interventions that specifically focus on economic promotion among women will provide me with a unique skill set possessed by only a handful of researchers in the field, particularly among researchers focusing on both GBV and HIV. The training aims will be accomplished through a combination of formal and/or informal coursework in economic development strategies and measures, structural interventions, and rigorous evaluation methodologies, as well as practical experience in the implementation and evaluation of a structural intervention. The proposed research aims to pilot a multi-strategy structural intervention combining community mobilization to promote gender equity alongside an economic intervention (microfinance and business training) in order to reduce gender-based violence and HIV risk among female sex workers (FSW) in Tijuana, Mexico. The program will be called ESTIMA: """"""""Empowerment of Sex workers to Increase Social and Economic Mobility. The evaluation will employ a randomized controlled design, recruiting FSW (n=120, 60 in each arm) who will be randomized to: 1) ESTIMA (gender equity/community mobilization program and economic intervention) or 2) a wait-list control group. For this preliminary work, at 12 months follow-up, w hypothesize that compared to control participants, intervention participants will have: 1) significantly greater economic security (e.g. decreased debt, increased income, decreased number of sex trades) and 2) significantly greater perceived collective power (i.e. collective efficacy) to address gendered power imbalances within social structures and the community. The long-term goal of this program, upon future refinement and large scale implementation, is to reduce HIV risk behaviors, STI/HIV, GBV, and ultimately, alleviate a multitude of health burdens among women. Furthermore, we expect that such work will highlight the need for HIV prevention initiatives in Mexico, and elsewhere, to more broadly consider women's 'life contexts'- addressing economic and social burdens in women's lives, to reduce the burden of poverty, gender, and HIV, as well as the intersection of these among women.
The proposed research aims to pilot a multi-strategy structural intervention combining community mobilization to promote gender equity alongside an economic intervention (microfinance and business training) in order to reduce gender-based violence and HIV risk among female sex workers (FSW) in Tijuana, Mexico. Testing a combined program, for the first time among FSW, could have global implications, particularly in developing regions where poverty, gender inequity, and HIV converge. Furthermore, the proposed training on economic interventions will allow the candidate to obtain a unique combination of skills possessed by only a handful of researchers in the field globally, particularly among researchers focusing on both GBV and HIV.
|Reed, Elizabeth; Fisher, Celia B; Blankenship, Kim M et al. (2017) Why female sex workers participate in HIV research: the illusion of voluntariness. AIDS Care 29:914-918|
|Shakya, Holly B; Fariss, Christopher J; Ojeda, Christopher et al. (2017) Social Network Clustering of Sexual Violence Experienced by Adolescent Girls. Am J Epidemiol 186:796-804|
|Reed, Elizabeth; Erausquin, Jennifer Toller; Biradavolu, Monica et al. (2017) Non-barrier contraceptive use and relation to condom use behaviour by partner type among female sex workers in Andhra Pradesh, India. J Fam Plann Reprod Health Care 43:60-66|
|Raj, Anita; Ghule, Mohan; Ritter, Julie et al. (2016) Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India. PLoS One 11:e0153190|
|Reed, Elizabeth; Saggurti, Niranjan; Donta, Balaiah et al. (2016) Intimate partner violence among married couples in India and contraceptive use reported by women but not husbands. Int J Gynaecol Obstet 133:22-5|
|Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita et al. (2016) Access to Money and Relation to Women's Use of Family Planning Methods Among Young Married Women in Rural India. Matern Child Health J 20:1203-10|
|Reed, Elizabeth; Erausquin, J T; Groves, Allison K et al. (2016) Client-perpetrated and husband-perpetrated violence among female sex workers in Andhra Pradesh, India: HIV/STI risk across personal and work contexts. Sex Transm Infect 92:424-9|
|Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita et al. (2015) Household Debt and Relation to Intimate Partner Violence and Husbands' Attitudes Toward Gender Norms: A Study Among Young Married Couples in Rural Maharashtra, India. Public Health Rep 130:664-71|
|Reed, Elizabeth; Myers, Bronwyn; Novak, Scott P et al. (2015) Experiences of violence and association with decreased drug abstinence among women in Cape Town, South Africa. AIDS Behav 19:192-8|
|Raj, Anita; McDougal, Lotus; Reed, Elizabeth et al. (2015) Associations of marital violence with different forms of contraception: cross-sectional findings from South Asia. Int J Gynaecol Obstet 130 Suppl 3:E56-61|
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