Pervasive sexual and gender based violence (SGBV) in Eastern Democratic Republic of Congo (DRC) causes severe outcomes for the physical, psychological, and economic health of young women. Research is currently being conducted to determine the effects of village-led microfinance in reintegrating SGBV survivors into their families and communities to improve women's physical, psychological, and economic health. However, current research has shown that post-rape services are not reaching young unmarried women between the ages 15 to 24 in the region. Young women of this age are highly vulnerable to HIV/AIDS, particularly after a traumatic event such as an incident of SGBV. This study will investigate how microfinance affects the mental health and HIV sexual risk behavior of young unmarried women within an existing study. Research participants will be asked to self-report HIV sexual risk behavior in a series of survey questions. Risk behaviors such as multiple sexual partners and condom usage will be measured at baseline, and 3, 6, 12, and 18 months post-baseline. A secondary data analysis will be conducted comparing HIV sexual risk behavior with demographic and mental health measures over time. Although sexual risk behavior data will be collected for 500 women in both the microfinance intervention group (n=250) compared to the delayed control group (n=250), this study will focus on the effects of microfinance on HIV sexual risk behaviors of young unmarried women between the ages of 15-24. It is hypothesized that young unmarried women in the intervention group will report fewer sexual risk behaviors than women in the delayed control group. In-depth qualitative interviews with a subsample of young unmarried women (n=50, five from each of the ten villages) will explore reasons behind status of health, mental health, and HIV sexual risk behavior. Of particular interest in these interviews is the relationship between conflict-setting and SGBV trauma, a microfinance intervention, and sexual risk behavioral outcomes. Interviews will be conducted at baseline and 18 months post-intervention to compare the types of responses and evaluate the impact of microfinance in the lives of young unmarried women with regards to coping with traumatic experiences and impact on HIV sexual risk behaviors. Collaboration between the study investigator and local Congolese experts trained in sensitive (to SGBV survivors) research methods will explore how trauma survivors view microfinance and if microfinance has affected their sexual risk behaviors. Acknowledging safety concerns for participants and researchers in this conflict setting, every precaution will be taken through the complex safety system that Congolese partners have developed over the past fifteen years of successfully working in this conflict setting. Interviews will take place in a safe participant-selected setting for 90 minutes, asking open-ended questions, and only exploring what young women are comfortable with.

Public Health Relevance

This study investigates how microfinance affects the mental health outcomes and HIV/AIDS sexual risk behaviors of young unmarried women participating in an existing research study in the post-conflict setting of Eastern Democratic Republic of Congo. Mixed-methods (quantitative and qualitative) research will explore how young female trauma survivors are affected by a microfinance intervention and the intervention's impact on sexual risk behaviors.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Predoctoral Individual National Research Service Award (F31)
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Special Emphasis Panel (ZRG1)
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Stoff, David M
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Johns Hopkins University
Public Health & Prev Medicine
Schools of Public Health
United States
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