Intervention in Uganda aims to stem HIV through economic empowerment for women

Nearly 1,000 women engaged in sex work in Uganda are being provided with savings accounts, financial literacy skills and vocational training in a study currently underway by researchers from the Brown School at Washington University in St. Louis.

“When women engaged in sex work have access to alternative forms of employment and start earning formal income outside of sex work, they may become motivated to explore alternative sources of income and ultimately reduce their exposure to HIV and other sexually transmitted infections,” said Fred Ssewamala, the William E. Gordon Distinguished Professor at the Brown School and a principal investigator for the study.


“We hope the study findings will advance our understanding of how best to implement gender-specific HIV prevention globally,” he said.

The outline of the study, “A Combination Intervention Addressing Sexual Risk-taking Behaviors Among Vulnerable Women in Uganda: Study Protocol for a Cluster Randomized Clinical Trial,” was published in August in the journal BMC Women’s Health.

Investigators hope that improving the women’s financial situations and job prospects will result in less sexual risk-taking and limit the spread of HIV.

Sub-Saharan Africa has the highest number of people living with HIV/AIDS, with Nigeria, South Africa and Uganda accounting for 48% of new infections. Women in sex work are at increased risk, and poverty is the most common reason for sex work.

The randomized control trial is recruiting 990 women engaged in sex work to participate in the five-year study, which began in 2018 and is funded by a $3 million grant from the National Institute of Mental Health.

One-third of the women will be given traditional HIV risk-reduction training. Another one-third will also receive a savings account that will match the savings that women deposit, along with financial literacy training on subjects such as budgeting and asset building. The last one-third will receive vocational training in addition to the other elements of the intervention.

Ssewamala is also the director of the SMART Africa Center, which is aimed at reducing gaps in child and adolescent mental health services and conducting research in Ghana, Kenya and Uganda.

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