Promoting Women’s Employment, Income and Livelihood Opportunities

1. Increased employment opportunities, microfinance, or small-scale income-generating activities can reduce behavior that increases HIV risk, particularly among young people. *

Secondary analysis of quantitative and qualitative data in South Africa from IMAGE (Pronyk et al., 2006) found that after two years of follow-up, young women ages 14 to 35 who had received microfinance loans to establish small businesses, along with training on gender and HIV, were more likely to have accessed VCT and less likely to have had unprotected sex at last intercourse, as well as being more likely to have had more communication concerning HIV with sexual partners and others. “…Data from focus group discussions and key informant interviews indicated a sense of enhanced bargaining power among intervention participants” (Pronyk et al., 2008a: 1663). Qualitative data from non-participant observation of 160 women attending microfinance loan meetings during one year, focus group discussions, key informant interviews and diaries of training facilitators were used along with quantitative data. One hundred and twelve women in the intervention group and 108 in the control group were followed and interviewed. 

[*] Note: In some cases, microcredit can increase violence against women if the intervention is not carefully designed and appropriate to the local context (Schuler et al., 1998; Gupta et al., 2008a; Dunbar et al., 2010).

In Haiti, access to microfinance loans improved the well-being of women who received the loans between 2005 and 2007. Through the program, 420 women (of whom 57% were HIV-positive) who were screened for HIV infection at GHESKIO received a loan from a microfinance institution following evaluation and training on business development. Of the women, 85% reported that the loans had improved their life conditions. The women were followed for a median of 12 months from the time of the first loan until the most recent clinic visit. Loan repayment was high: 95% for HIV-negative women and 93% for women living with HIV. An impact evaluation among the first 66 women receiving loans found significant differences in women’s ability to feed, clothe, and house themselves compared to women in a control group. Although not statistically significant, among the group receiving the loans, 6% said that they received money for sex, compared to 16% in the control group.

A time-usage study in 1999 that analyzed data on education, work, and organized activities among 2,992 youths ages 14-22 in two South African districts found that employment opportunities decreased the odds of sexual activity among girls and higher wages for both boys and girls were associated with increased condom use. For example, girls were about one-third less likely to have had sex in the last year in communities where youth generally made more money from working and were almost two and a half times more likely to report having used a condom. Boys living in communities with higher employment and wage rates were 50% more likely to report having used a condom. Overall, “for most groups, the number of hours spent hanging out is positively associated with having had sex in the last year and negatively associated with condom use” (Kaufman et al., 2002: 16).

Four years after an income-generating HIV prevention project for youth was initiated in Ewo, Republic of Congo, a follow up inquiry found that 24.2% of the youth were still involved in income generating activities. The follow up visit in 2006 used focus groups and a cross sectional survey of 372 young people ages 15-24, selected from four zones through cluster sampling to explore practices associated with risk of HIV in young people. Youth reported that, for those who continued with the income-generating activities, these activities provided them with money and, for some, skills training, which for the girls especially, reduced their dependency on others. Few (5%) reported having sexual intercourse with a new sexual partner without using a condom and this was significantly lower in those currently involved in income generating activities. Young people involved in agriculture, however, reported higher levels of sexual intercourse with a new sexual partner without using a condom. The focus group discussions pointed out that farm activities were carried out in neighboring villages and some on a seasonal basis. This may imply an increase on other risk factors such as insecure income, exposure to non-familiar adults and mobility. Further assessment is needed, however, to understand the factors driving the behavior of the young people involved in agriculture. Researchers found that for the youth in Ewo, there are four dimensions of income generating activities that are reported to be important for reducing susceptibility to HIV: the revenue they earned, the control/autonomy it brings to their lives, the training and new skills and the occupation of time in useful activity. Mobility and exposure to non-familiar adults in insecure forms of activity may counter some of these beneficial effect.

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