Article

Sherman SG, German D, Cheng Y, Marks M, Bailey-Kloche M. The evaluation of the JEWEL project: an innovative economic enhancement and HIV prevention intervention study targeting drug using women involved in prostitution

Department of epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
AIDS Care (Impact Factor: 1.6). 02/2006; 18(1):1-11. DOI: 10.1080/09540120600838480
Source: PubMed

ABSTRACT

The JEWEL (Jewellery Education for Women Empowering Their Lives) pilot study examined the efficacy of an economic empowerment and HIV prevention intervention targeting illicit drug-using women (n=50) who were involved in prostitution in Baltimore, Maryland. The intervention was comprised of six 2-hour sessions that taught HIV prevention risk reduction and the making, marketing and selling of jewellery. Bivariate comparisons examined behaviour change pre- and 3-months post-intervention. The intervention's effect on the change in the number of sex trade partners from baseline to follow-up was explored with multiple linear regression. Participants were 62.0% African American, 5.0% were currently employed, and the median age was 39 years old (Inter Quartile Range [IQR]: 34-45). Women attended an average of six (IQR: 4.5-6.0) sessions. The women sold over $7,000 worth of jewellery in eleven sales. In comparing self-reported risk behaviours pre and 3-month post intervention participation, we found significant reductions in: receiving drugs or money for sex (100% versus 71.0%, p<0.0005); the median number of sex trade partners per month (9 versus 3, p=0.02); daily drug use (76.0% vs. 55.0%, p=0.003); the amount of money spent on drugs daily (US$52.57 versus US$46.71, p = 0.01); and daily crack use (27.3% versus 13.1.0%, p = 0.014). In the presence of other variables in a multivariate linear model, income from the jewelry sale was associated with a reduction in the number of sex trade partners at follow-up. The pilot indicated effectiveness of a novel, HIV prevention, economic enhancement intervention upon HIV sexual risk behaviours and drug utilization patterns.

Download full-text

Full-text

Available from: Marie Bailey-Kloch, Jul 10, 2014
  • Source
    • "The economic vulnerability of women engaged in sex work is also closely related to their HIV risk (Choi and Holroyd, 2007; Reed et al., 2010). Women who engage in sex work and who have limited economic means may have inhibited power to negotiate safe sex practices with clients due to the higher premium gained through unprotected sex, the price of condoms, and urgent requirement for income in times of crisis or immediate need (Odek et al., 2009; Sherman et al., 2006). Women engaging in sex work who report having debt or other economic hardships have been more likely to report unsafe sex practices and sexually transmitted infection (STI) symptoms (Ngo et al., 2007; Reed et al., 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Diversifying options for income generation and employment may enhance health outcomes for women engaged in sex work. This randomized trial tested the efficacy of a microsavings intervention on reductions in economic dependence upon sex work and changes in income among women in Mongolia. Women who attended microfinance plus HIV prevention sessions reported a significantly lower percentage of income from sex work, increased odds of reporting no income from sex work, and increased odds that sex work was not their main source of income compared to women who received HIV prevention sessions alone. No significant changes in total income were observed in the treatment condition.
    Full-text · Article · Nov 2015 · International Social Work
  • Source
    • "Session Three. Stress Management Compared to men, low-income African American women have reported greater levels of physiological and psychological stress as they are confronted with " triple oppression associated with discriminations based on race, sex, and class " (Bova, et al. 2008; Sherman, et al. 2006; Braxton, et al. 2007; Williams & Williams-Morris, 2000; Hooks, 1993). This in turn, resulted in several exaggerated and negative coping mechanisms, including the tendency to engage in highrisk behaviors, and the reluctance to seek help and treatment (Murry, et al. 2003). "
    [Show abstract] [Hide abstract]
    ABSTRACT: HIV-positive individuals are living longer today as a result of continuing advances in treatment but are also facing an increased risk for chronic diseases such as diabetes, and hypertension. These conditions result in a larger burden of hospitalization, outpatient, and emergency room visits. Impoverished African American women may represent an especially high-risk group due to disparities in health care, racial discrimination, and limited resources. This article describes an intervention that is based on the conceptual framework of the socio-ecological model. Project THANKS uses a community-based participatory, and empowerment building approach to target the unique personal, social, and environmental needs of African American women faced with the dual diagnosis of HIV and one or more chronic diseases. The long-term goal of this project is to identify features in the social and cultural milieu of these women that if integrated into existing harm reduction services can reduce poor health outcomes among them.
    Full-text · Article · Jan 2014
  • Source
    • "Secondly, female drug users who exchange sex for drugs or cash may not identify themselves at risk of HIV infection because they do not consider themselves as sex workers [15]. Thirdly, condom use can be infrequent among them because drug dependency and financial problems may impair their judgment and power to negotiate for condom use with their sex partners [16-19]. Fourthly, female drug users depend in many cases on male partners for drugs and injections, leading them to an elevated risk of equipment sharing practice [20,21]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Women who use drugs are extremely vulnerable to HIV and sexually transmitted infections (STIs), but studies on risk behaviours and HIV infection among female drug users are limited in Nepal. In this cross-sectional study conducted between September 2010 and May 2011, HIV prevalence and risk factors for HIV infection were investigated among female drug users recruited in drop-in centres, parks and streets in the Kathmandu Valley. The participants completed face-to-face interviews for a structured questionnaire, HIV pre-test counselling, specimen collection for HIV test and they were provided with their results at post-test counselling. A total of 269 female drug users were recruited, of whom 28% (n = 77) were found HIV positive; the majority (78%, n = 211) being injecting drug users and aged below 25 years (57%, n = 155). Nearly half (n = 137) of the total participants had shared needles or syringes in the past month, and 131 and 102 participants were involved in commercial or casual sex respectively with only half or less of them having had used condoms in the last 12 months. In multivariate analysis the variables associated with HIV infection included: (a) older age; (b) history of school attendance; (c) frequency of sharing of injection instruments; and (d) unsafe sex with commercial or casual partners. HIV was highly prevalent among female drug users in the Kathmandu Valley, with its risk being strongly associated not only with unsafe injection practice but also with unsafe sexual behaviours. Awareness raising programmes and preventive measures such as condom distribution, needle or syringe exchange or methadone maintenance therapy should be urgently introduced in this neglected subpopulation.
    Full-text · Article · Dec 2013 · BMC Public Health
Show more