146 lines
4.8 KiB
YAML
146 lines
4.8 KiB
YAML
abstract: 'Introduction Female sex workers (FSW) who use drugs are a key population
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at risk of HIV in Kazakhstan, and face multiple structural barriers to
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HIV prevention. More research is needed on the role of structural
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interventions such as microfinance (MF) in reducing HIV risk. This paper
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describes the results of a cluster-randomized controlled trial to test
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the efficacy of a combination HIVRR + MF intervention in reducing
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biologically confirmed STIs and HIV risk behaviours.
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Methods This study took place from May 2015 to October 2018 in two
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cities in Kazakhstan. We screened 763 participants for eligibility and
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enrolled 354 FSW who use drugs. Participants were randomized in cohorts
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to receive either a four-session HIVRR intervention, or that same
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intervention plus 30 additional sessions of financial literacy training,
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vocational training and asset-building through a matched-savings
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programme. Repeated behavioural and biological assessments were
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conducted at baseline, 3-, 6- and 12-months post-intervention.
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Biological and behavioural primary outcomes included HIV/STI incidence,
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sexual risk behaviours and drug use risk behaviours, evaluated over the
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12-month period.
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Results Over the 12-month follow-up period, few differences in study
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outcomes were noted between arms. There was only one newly-detected HIV
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case, and study arms did not significantly differ on any STI incidence.
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At post-intervention assessments compared to baseline, both HIVRR and
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HIVRR + MF participants significantly reduced sexual and drug use risk
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behaviours, and showed improvements in financial outcomes, condom use
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attitudes and self-efficacy, social support, and access to medical care.
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In addition, HIVRR + MF participants showed a 72\% greater reduction in
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the number of unprotected sex acts with paying partners at the six-month
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assessment (IRR = IRR = 0.28, 95\% CI = 0.08, 0.92), and a 10\% greater
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reduction in the proportion of income from sex work at the three-month
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assessment (b = -0.10, 95\% CI = -0.17, -0.02) than HIVRR participants
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did. HIVRR + MF participants also showed significantly improved
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performance on financial self-efficacy compared to HIVRR over the
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12-month follow-up period.
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Conclusions Compared to a combination HIVRR + MF intervention, a robust
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HIVRR intervention alone may be sufficient to reduce sexual and drug
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risk behaviours among FSW who use drugs. There may be structural
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limitations to the promise of microfinance for HIV risk reduction among
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this population.'
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affiliation: 'El-Bassel, N (Corresponding Author), Columbia Univ, Sch Social Work,
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Global Hlth Res Ctr Cent Asia, 1255 Amsterdam Ave, New York, NY 10027 USA.
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El-Bassel, Nabila; McCrimmon, Tara; Chang, Mingway; Witte, Susan S., Columbia Univ,
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Sch Social Work, Global Hlth Res Ctr Cent Asia, 1255 Amsterdam Ave, New York, NY
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10027 USA.
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Mergenova, Gaukhar; Terlikbayeva, Assel; Primbetova, Sholpan; Kuskulov, Azamat,
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Global Hlth Res Cent Asia, Alma Ata, Kazakhstan.
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Baiserkin, Bauyrzhan, Kazakh Sci Ctr Dermatol \& Infect Dis, Alma Ata, Kazakhstan.
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Denebayeva, Alfiya, Almaty City Ctr Prevent \& Control AIDS, Alma Ata, Kazakhstan.
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Kurmetova, Kulpan, Karaganda Oblast Ctr Prevent \& Control AIDS, Temirtau Branch,
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Temirtau, Kazakhstan.'
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article-number: e25682
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author: El-Bassel, Nabila and McCrimmon, Tara and Mergenova, Gaukhar and Chang, Mingway
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and Terlikbayeva, Assel and Primbetova, Sholpan and Kuskulov, Azamat and Baiserkin,
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Bauyrzhan and Denebayeva, Alfiya and Kurmetova, Kulpan and Witte, Susan S.
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author-email: ne5@columbia.edu
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author_list:
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- family: El-Bassel
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given: Nabila
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- family: McCrimmon
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given: Tara
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- family: Mergenova
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given: Gaukhar
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- family: Chang
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given: Mingway
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- family: Terlikbayeva
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given: Assel
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- family: Primbetova
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given: Sholpan
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- family: Kuskulov
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given: Azamat
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- family: Baiserkin
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given: Bauyrzhan
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- family: Denebayeva
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given: Alfiya
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- family: Kurmetova
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given: Kulpan
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- family: Witte
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given: Susan S.
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da: '2023-09-28'
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doi: 10.1002/jia2.25682
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eissn: 1758-2652
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files: []
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journal: JOURNAL OF THE INTERNATIONAL AIDS SOCIETY
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keywords: 'structural interventions; sex workers; drug use; HIV prevention;
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clinical trials'
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keywords-plus: SUBSTANCE USE; INJECT DRUGS; WOMEN; PREVENTION; VIOLENCE; INCOME; SCALE
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language: English
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month: MAY
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number: '5'
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number-of-cited-references: '29'
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papis_id: eef62caebf9728fb02de4abbfc8fd9d3
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ref: Elbassel2021clusterrandomizedcon
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researcherid-numbers: McCrimmon, Tara/GRR-3918-2022
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times-cited: '4'
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title: A cluster-randomized controlled trial of a combination HIV risk reduction and
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microfinance intervention for female sex workers who use drugs in Kazakhstan
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type: article
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unique-id: WOS:000655909900015
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '24'
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web-of-science-categories: Immunology; Infectious Diseases
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year: '2021'
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