Cambodian female entertainment and sex workers (FESW) face HIV risk due to the co-occurrence of sexual risk and amphetamine type stimulant (ATS) use, and socioeconomic disparities. The Cambodia Integrated HIV/Drug Use Prevention Intervention (CIPI), an intervention trial aimed at ATS use and sexual risk among FESW, is evaluating a 16-week behavioral intervention program to reduce ATS use, and examining the effectiveness of a microenterprise (ME) program for FESW in 10 Cambodian provinces.
As part of the CIPI Study, we developed a structured ME program including: (1) a three-day financial literacy (FL) training program tailored to local context and participant literacy; and (2) a microloan opportunity. Eligible FESW from CIPI are invited to participate. CIPI participants who were using ATS were required to complete a 16-week behavioral intervention program to reduce ATS use in order to participate in ME. Both quantitative and qualitative are collected to assess intervention feasibility and acceptability.
To date, 199 FESW consented to ME; 19 (10%) of whom had completed the ATS reduction intervention for substance-using FESW. 182 (91%) completed FL training and 41 (20%) applied for small-business microloans. Of the 41 loan applications, 29 (71%) were funded for an average loan amount of $262USD; repayment rates are 69%. Of 29 loan recipients, 20 businesses are active. Qualitative data suggest that loans are used to start independent businesses or expand family businesses. Those who attended the FL training but did not file a loan application cited concerns about borrowing money, the burden of interest payments, and lack of skills/motivation to start a business, but described changes in their thinking about money management, future goals, and possible alternatives to sex/entertainment work as a result of attending the FL training.
These data demonstrate the feasibility of a microenterprise (ME) program for Cambodian FSEW, including those who were previously using ATS. Small businesses may result in improved economic circumstances and reduced HIV risk for loan recipients and a brief FL training alone appears to be valuable. Additional analyses will be completed when the CIPI trial concludes, to further elucidate the effectiveness of ME on HIV risk behavior among FSEW.