Conceptualization of Empowerment and Pathways Through Which Cash Transfers Work to Empower Young Women to Reduce HIV Risk: A Qualitative Study in Tanzania

Joyce Wamoyi,Audrey Pettifor,Esther Majani,Peter Balvanz,Suzanne Maman,Kaitlyn Atkins,Margaret Gichane

doi:10.1007/s10461-020-02850-0

Abstract

Although cash transfers (CT) are hypothesized to reduce AGYW’s HIV risk, little is known about the mechanisms through which CT empower AGYW. We explored the impact of a CT intervention on AGYW’s sexual decision-making in order to describe the pathways through which the cash may influence risk behavior. The study employed qualitative methods involving: 20 longitudinal in-depth interviews (IDIs), 40 cross-sectional IDIs, 20 narrative IDIs, and two focus group discussions with AGYW ages 15–23 participating in a CT intervention. AGYW’s conceptualized empowerment as: “independence”, “hope and aspiration”. Potential pathways through which CT empowered AGYW were: economic, hope and aspiration for a better future, and access to knowledge. As a result of this empowerment, AGYW reported reductions in transactional sex, experiences of intimate partner violence, and risky-sexual behaviour. A sense of responsibility developed through economic empowerment, enhanced participants’ self-esteem and confidence in decision-making leading to changes in AGYW’s sexual risk behaviors.

Highlights

Adolescent girls and young women (AGYW) in sub-Saharan Africa make up 10% of the total population, yet they account for 25% of the new HIV infections [1]
AGYW engage in risky sexual behaviours such as multiple and concurrent sexual partnerships, age-disparate sex, transactional sex, and unprotected sex [3,4,5]
The results are structured in three broad themes: emic conceptualization of empowerment, levels of empowerment and their impact on AGYW’s lives, and pathways of empowerment

Summary

Introduction

Adolescent girls and young women (AGYW) in sub-Saharan Africa make up 10% of the total population, yet they account for 25% of the new HIV infections [1]. Structural drivers such as poverty and gender inequalities increase AGYW’s HIV risk [2]. The strategies programmes use to empower women vary from one context to another. Empowerment is both a state and a process that involves enhancing the capacity of individuals to make choices and to transform those choices to desired actions and outcomes. Women’s empowerment entails the improvement in their ability to manage their own lives

Methods

Results

Discussion

Conclusion