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Microenterprise Development Interventions for Sexual Risk Reduction: A Systematic Review

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Abstract

Comprehensive interventions that address both individual and structural determinants associated with HIV/STI risk are gaining increasing attention over the past decade. Microenterprise development offers an appealing model for HIV prevention by addressing poverty and gender equality. This study systematically reviewed the effects of microenterprise development interventions on HIV/STI incidence and sexual risk behaviors. Microenterprise development was defined as developing small business capacity among individuals to alleviate poverty. Seven eligible research studies representing five interventions were identified and included in this review. All of the studies targeted women, and three focused on sex workers. None measured biomarker outcomes. All three sex worker studies showed significant reduction in sexual risk behaviors when compared to the control group. Non-sex worker studies showed limited changes in sexual risk behavior. This review indicates the potential utility of microenterprise development in HIV risk reduction programs. More research is needed to determine how microenterprise development can be effectively incorporated in comprehensive HIV control strategies.

Resumen

Intervensiones exhaustivas que abordan los determinantes, tanto individuales como estructurales, asociados a los riesgos, de índole, del virus de la inmunodeficiencia humana (VIH) y enfermedades de transmisión sexual (ETS), han estado atrayendo cada vez más atención en la última década. El desarrollo de la microempresa ofrece un modelo atractivo para la prevención del VIH, abordando la pobreza y la igualdad de género. El presente estudio revisó, sistemáticamente, los efectos de la intervenciones de las microempresas en la incidencia del VIH/ETF y comportamientos de riesgo sexual. El desarrollo de la microempresa se define como “el desarrollo de la capacidad de pequeños negocios entre individuos para aliviar la pobreza”. Siete estudios eligibles, representando cinco intervenciones, fueron identificados e incluidos en esta revisión. Los estudios se centraron en la mujer, y tres de estos se enfocaron en trabajadoras sexuales. Ningun estudio midió biomarcadores. Los estudios de trabajadoras sexuales mostraron una reducción significante en las conductas de riesgo sexual en el grupo intervenido, en comparación con el grupo control. Estudios de las no laboradoras en la industria del sexo mostraron cambios limitados con respecto al comportamiento de riesgo sexual. Esta revisión indica el uso potencial del desarrollo de las microempresas en los programas de reducción del riesgo al VIH. Más investigación es necesaria en el campo de planificación de estas estrategias y como incorporarlas efectivamente en las medidas de prevencion del VIH.

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Acknowledgments

All authors assisted with analysis and interpretation of the data, reviewed the manuscript for important intellectual content, and provided final approval of the version submitted for publication. Special thanks to the UNC Center for AIDS Research, Guangdong Provincial STD Control Center and UNC Project-China for administrative support. The authors would also like to thank Rebecca Martinez and Oscar Galagarza for the Spanish translation of the abstract.

Conflicts of interest

The authors have no conflicts of interest.

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Authors and Affiliations

  1. Columbia University College of Physicians and Surgeons, UNC Project-China, 60 Haven Ave. Apt 17D, New York, NY, 10032, USA

    Rosa R. Cui

  2. Harvard Medical School Boston, Boston, MA, USA

    Ramon Lee

  3. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Harsha Thirumurthy

  4. University of North Carolina at Chapel Hill, UNC Project-China, Chapel Hill, NC, USA

    Kathryn E. Muessig

  5. University of North Carolina at Chapel Hill, School of Medicine, UNC Project-China, Chapel Hill, NC, USA

    Joseph D. Tucker

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  1. Rosa R. Cui
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Correspondence to Rosa R. Cui.

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Cui, R.R., Lee, R., Thirumurthy, H. et al. Microenterprise Development Interventions for Sexual Risk Reduction: A Systematic Review. AIDS Behav 17, 2864–2877 (2013). https://doi.org/10.1007/s10461-013-0582-1

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