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  • 1
    Language: English
    Pages: 1 Online-Ressource (32 pages)
    Parallel Title: Erscheint auch als Balampama, Marianna Effects of a Lottery Incentive on Sexually Transmitted Infections and HIV Incidence among Female Sex Workers in Tanzania: Results from the Respect II Randomized Trial
    Keywords: Communicable Diseases ; Female Sex Worker Intervention ; Financial Incentives To Safe Sex ; Health, Nutrition and Population ; HIV Among Sex Workers ; HIV Prevention ; Lottery Incentive Case Study ; Public Health Promotion ; STD Prevention
    Abstract: Female sex workers are a key population who experience a disproportionately high burden of HIV and sexually transmitted infections. A growing body of evidence suggests that financial incentives can reduce risky sexual behavior and the incidence of HIV and sexually transmitted infections; however, few studies have examined a lottery-based incentive mechanism or been conducted with female sex workers. This paper examines the effect of a lottery intervention on the combined incidence of HIV and herpes simplex virus 2 among female sex workers in Tanzania. The RESPECT II trial was an unmasked, two-arm, parallel group randomized controlled trial conducted in Dar es Salaam, Tanzania among 2,206 enrollees from 2018 to 2021. Participants were randomized in a one-to-one ratio to the basic test control group or to the lottery intervention group. The basic test group received testing and counseling for HIV and biweekly text messages with information on safe sex practices. The lottery group received the basic test group intervention plus entry into a weekly lottery with a 100,000 Tanzanian shilling (USD 50) reward offered to 10 randomly selected participants, conditional on negative test results for syphilis and trichomonas. The primary outcome was combined HIV and herpes simplex virus 2 incidence after 36 months. The results showed no statistically significant effect on this primary outcome. Thus the study finds no evidence that the lottery-based incentives reduced the incidence of HIV and sexually transmitted infections among the female sex worker population. However, the results may have been affected by disruption from the COVID-19 pandemic, and unexpectedly high study attrition levels made it impossible to statistically rule out possible moderate-sized effects
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  • 2
    Language: English
    Pages: 1 Online-Ressource (18 pages)
    Parallel Title: Erscheint auch als Balampama, Marianna Influence of COVID-19 on Female Sex Workers in Dar Es Salaam, Tanzania: A Mixed-Methods Analysis
    Keywords: COVID-19 Impact on Sex Workers ; Extreme Financial Vulnerability ; Female Sex Worker Welfare ; Food Insecurity ; Gender ; Gender and Poverty ; Gender and Social Policy ; Health, Nutrition and Population ; Labor Law ; Social Protections and Labor ; Urban Homelessness
    Abstract: This study investigates how the landscape of sex work in Dar es Salaam, Tanzania, evolved in the context of the COVID-19 epidemic. Using a mixed-methods approach, the analysis triangulates data from quantitative and qualitative sources to quantify shifts in income, demand, and client frequency and describe female sex workers' perspectives on their work environment. The COVID-19 restrictions introduced in early 2020 resulted in dramatic decreases in sex work income, leading to extreme financial vulnerability, food insecurity, and challenges in meeting other basic needs such as paying rent. However, in a 2021 follow-up survey, sex workers reported the summer of 2021 as a key turning point, with the demand for sex work rebounding to closer to pre-pandemic levels. Notably, despite the average number of unique weekly clients not yet having fully rebounded, by 2021 the price per client and the total monthly sex work income had returned to pre-pandemic levels. This may potentially be explained by an increased number of repeat clients, which represented a larger proportion of all clients during the COVID-19 pandemic
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