Microfinance and Health Intervention Trial for Youth in Dar es Salaam, Tanzania
Condition: Sexually Transmitted Infections; Domestic Violence
MeSH terms: Sexually Transmitted Diseases
Study type: Interventional

Summary: 
      Young men who are members of the camps randomized to receive a microfinance and health
      leadership intervention will have a lower incidence of sexually transmitted infections
      (Neisseria gonorrhea (NG), Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) and
      report perpetrating less physical or sexual violence against sexual partners as compared to
      young men who are members of camps not randomized to receive the intervention.
    

Detailed description: 
      Finding effective strategies to reach out to young men and mobilize them to reduce their HIV
      risk is critical, given men's control over the terms and conditions of most sexual
      partnerships. Unequal power distribution in relationships has a devastating impact on women,
      leading to HIV prevalence among young women in some sub-Saharan African countries four to
      seven times higher than among young men the same age. Gender power differentials have
      negative consequences for men as well, leading to increased risk of physical and mental
      health problems, substance use, and low uptake of health-related services. We need innovative
      approaches to address the structural and social determinant of young men's risk. Lack of
      economic opportunity is a key structural determinant of risk that has negative consequences
      for men, and has been linked to poor health outcomes. The influence of social network members
      is a social determinant of risk for both HIV and gender-based violence that can be addressed
      through interventions designed to change network norms. For the past 12 years our group has
      conducted research in Dar es Salaam, Tanzania on HIV and gender-based violence. With support
      from the National Institute of Mental Health (NIMH) we identified networks of young men who
      socialize in what are called "camps" and we successfully piloted a microfinance and health
      leadership intervention with men in camps like the one proposed in this application (R21
      MH080577). Camps are enduring social groups of mostly men that have elected leadership, paid
      membership fees, and physical space to meet. The equivalent of a camp in US culture may be a
      cross between a club and a gang. Camps appear to be an urban phenomenon in Tanzania and our
      group is the first to have published data describing them. Men in camps engage in HIV risk
      behavior and in gender-based violence that put them and their partners at risk for HIV.
      Research suggests that microfinance combined with health promotion can lead to improvement in
      health outcomes, including reductions in HIV risk and gender-based violence. However, few, if
      any well designed evaluations of microfinance and health programs with young men have been
      reported.
    

Intervention name(s): Microfinance and Health Leadership
Intervention type(s): Behavioral
Intervention description(s): Microfinance and Health Leadership: Participants will be eligible to receive small loans and business training as part of the microfinance component. Nominated leaders in camps will receive health leadership training on prevention of HIV risk behaviors and gender based violence perpetration, and then pass on knowledge to camp members.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention