Abstract
BackgroundWomen who engage in sex work are at risk for experiencing violence from numerous perpetrators, including paying partners. Empirical evidence has shown mixed results regarding the impact of participation in microfinance interventions on women’s experiences of violence, with some studies demonstrating reductions in intimate partner violence (IPV) and others showing heightened risk for IPV. The current study reports on the impact of participation in a microsavings intervention on experiences of paying partner violence among women engaged in sex work in Mongolia.MethodsBetween 2011 and 2013, we conducted a two-arm, non-blinded randomized controlled trial (RCT) comparing an HIV/STI risk reduction intervention (HIVSRR) (control condition) to a combined microsavings and HIVSRR intervention (treatment condition). Eligible women (aged 18 or older, reported having engaged in unprotected sex with paying partner in past 90 days, expressed interest in microsavings intervention) were invited to participate. One hundred seven were randomized, including 50 in the control and 57 in the treatment condition. Participants completed assessments at baseline, immediate post-test following HIVSRR, and at 3-months and 6-months after completion of the treatment group intervention. Outcomes for the current study include any violence (physical and/or sexual), sexual violence, and physical violence from paying partners in the past 90 days.ResultsAn intention-to-treat approach was utilized. Linear growth models revealed significant reductions over time in both conditions for any violence (β = −0.867, p < 0.001), physical violence (β = −0.0923, p < 0.001), and sexual violence (β = −1.639, p = 0.001) from paying partners. No significant differences between groups were found for any violence (β = 0.118, p = 0.389), physical violence (β = 0.091, p = 0.792), or sexual violence (β = 0.379, p = 0.114) from paying partners.ConclusionsMicrosavings participation did not significantly impact women’s risk for paying partner violence. Qualitative research is recommended to understand the cause for reductions in paying partner violence in both study conditions.Trial registrationEvaluating a Microfinance Intervention for High Risk Women in Mongolia; NCT01861431; May 20, 2013.
Highlights
Women who engage in sex work are at risk for experiencing violence from numerous perpetrators, including paying partners
Prior evaluations of microfinance interventions with women engaged in sex work have found that microfinance participation led to significant reductions in sexual risk behavior and decreased engagement in sex work [13,14,15,16]
The purpose of the current study was to examine the efficacy of a combined HIV/STI sexual risk reduction (HIVSRR) plus microsavings condition and a HIV/STI risk reduction intervention (HIVSRR) alone condition at reducing recent paying partner violence against women engaged in street-based sex work in Mongolia
Summary
Women who engage in sex work are at risk for experiencing violence from numerous perpetrators, including paying partners. The current study reports on the impact of participation in a microsavings intervention on experiences of paying partner violence among women engaged in sex work in Mongolia. Carlson and colleagues (2012) found that 56 % of women engaged in street-based sex work in Ulaanbaatar, Mongolia reported experiencing physical violence from paying partners and 33 % reported experiencing sexual violence from paying partners in the past 90 days [9]. Exposure to paying partner violence places women at higher risk for physical and behavioral health issues, including elevated HIV/STI exposure, alcohol and substance use/abuse, unwanted pregnancy, abortion, and physical injuries, among others [3, 5, 6, 8, 9, 11]. Care must be taken when developing these public health interventions to not inadvertently increase risk for violence [17]
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