Intervention with Microfinance for AIDS and Gender Equity 2001-2003 - South Africa

Abstract
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In 1999, in response to the escalating AIDS epidemic in South Africa, the National Department of Health established a new initiative to design, implement and evaluate strategies for addressing HIV/AIDS within three pilot sites across the country. All three sites we re responsible for implementing a core re package of HIV- related services and support, including the provision of voluntary counselling and testing services and the training of health care workers in the implementation of National HIV/AIDS clinical care guidelines. However, in addition to this basic package, the pilot sites we re encouraged to test more innova t i ve and multi-sectoral approaches to HIV control, and it is in this context that the IMAGE (Intervention with micro-finance for AIDS and Gender Equity) Study was developed.

The IMAGE study 2001-2003 is a programme of intervention research based in Sekhukhuneland - a densely settled rural area of South Africa’s Limpopo Province. Collaborative partners include a microfinance NGO, the Small Enterprise Foundation (SEF), academic institutions from the South and North - the University of the Witwatersrand's Rural AIDS & Development Action Research Programme (RADAR) and the London School of Hygiene and Tropical Medicine - and national government (South African National Department of Health).

The study combines a poverty alleviation programme and participatory learning and action intervention. The intervention comprises participation in a micro-finance programme, the Small Enterprise Foundation Credit Program, (TCP) which is a poverty-targeted micro-finance programme operating in the Limpopo Province. Participants also take part in the "Sisters for Life" programme, a two phase participatory learning and action curriculum developed in South Africa, and implemented with TCP clients during fortnightly centre meetings. The IMAGE study seeks to evaluate the impact of this work among clients, their households and their communities. The research provides an opportunity to explore the potential for developmental programs to prevent HIV infections and gender-based violence.The study is built around the prospective follow-up of three cohorts: IMAGE clients, young people living in the household of IMAGE clients and young people living in communities where the IMAGE programme was operating.

Geographic coverage
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The study covers eight villages in the Sekhukhuneland region of South Africa's rural Limpopo Province.

Analysis unit
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Households and individuals

Universe
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The study universe includes all individuals aged 14-35 years in selected households in the eight participating villages.

Kind of data
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Sample survey data

Sampling procedure
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All households in the selected villages were eligible for inclusion in the IMAGE Study Baseline survey. Households in settlement areas outside village boundaries were not included in the sampling frame. 200 households were randomly selected in each of the eight study villages (total sample size 1600). A household in this study was defined as a group of people who are permanently resident on the same property (or dwelling) and who eat from the same pot of food when staying at home. Within selected households, all individuals aged 14-35 years at the date of interview were eligible for inclusion in the study. Individuals listed as permanent household members we re eligible for inclusion, including those household members staying staying away from the home. The total expected sample size, including adjustment for people who refuse and those who could not be traced, was 3000.

Mode of data collection
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Face-to-face [f2f]

Research instrument
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Cohort Study I: The impact of IMAGE on loan recipients
Study procedures : Baseline:Each loan recipient and non-loan recipient was interviewed at this stage with a standardised questionnaire (Senior Female Questionnaire). Additionally, information on the household was gathered at this point in an interview either with the woman, or with the head of the household (using the Household Questionnaire).
Study procedures : Follow up:Loan recipients and non-loan recipients were re-interviewed using an adapted version of the above questionnaires two years after enrolment of the loan recipient to IMAGE. Follow-up interviews were conducted with all women enrolled at baseline, including those who later dropped out of IMAGE. An effort was made to interview women who had moved out of their home during this two years of follow-up, but who were still traceable at that point.

Cohort Study II: The impact of IMAGE on young-people living in the households of loan recipients
Study procedures : Baseline: The baseline state for Cohort Study II was as for Cohort Study I. Young people were interviewed within two months of loan recipient/non loan recipient interviews being conducted, where possible.
Interviews were conducted using a standardised questionnaire (Young Person Questionnaire). Study recruits were also asked to provide a sample collected from inside the mouth (Oral Mucosal Transudate, or OMT), using a specially designed collection device to test for the presence of antibodies to HIV.
Study procedures: Follow-up: Follow up interviews with young people were conducted two years after their enrolment in the study, utilising a modified version of the Young Person Questionniare. Repeat OMT samples were also collected at this time.

Cohort Study III: The impact of IMAGE on communities
Study procedures : Baseline: A survey covering all villages was conducted during the three months prior to IMAGE being made available in the Intervention villages. Household Questionnaires and Young Person Questionnaires were completed in all selected households. Study recruits were asked to provide a sample of Oral Mucosal Transudate (OMT), using a specially designed collection device which tests for the presence of antibodies to HIV.
Study procedures: Follow up: Households and individuals interviewed in the baseline survey were re-interviewed during a final survey conducted three years after the introduction of IMAGE to Intervention villages. Repeat OMT samples were also collected at this time.

摘要
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1999年，针对南非日益严重的艾滋病疫情，南非国家卫生部门启动了一项新的举措，旨在设计、实施和评估在全国三个试点地点应对艾滋病（HIV/AIDS）的策略。这三个试点地点均负责实施一套核心的HIV相关服务和支援包，包括自愿咨询和检测服务以及培训医护人员执行国家HIV/AIDS临床护理指南。然而，除了这一基本包之外，试点地点还被鼓励测试更多创新和多部门的HIV控制方法，正是在此背景下，IMAGE（针对艾滋病和性别平等的微观金融干预）研究得以开展。

IMAGE研究（2001-2003年）是一项基于南非林波波省塞库胡伦兰（Sekhukhuneland）——一个人口密集的农村地区——的干预性研究项目。合作伙伴包括一家微型金融非政府组织——小企业基金会（SEF）、来自南北的学术机构——维特沃特斯兰德大学农村艾滋病与发展行动研究计划（RADAR）和伦敦卫生与热带医学院——以及国家政府（南非国家卫生部门）。

该研究结合了一个扶贫项目以及参与式学习和行动干预。干预措施包括参与小企业基金会信贷计划（TCP），这是一个以贫困为目标的微型金融项目，在林波波省运营。参与者还参加了“姐妹终身”项目，这是一个在南非开发的、在TCP客户每月中心会议上实施的分阶段参与式学习和行动课程。IMAGE研究旨在评估该工作对客户、他们的家庭和社区的影响。该研究提供了一个探索发展项目预防HIV感染和基于性别的暴力的潜力的机会。该研究围绕对三个队列的前瞻性随访而构建：IMAGE客户、生活在IMAGE客户家庭中的年轻人以及生活在IMAGE项目运营社区中的年轻人。

地理覆盖范围
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该研究覆盖了南非林波波省农村地区的塞库胡伦兰地区的八个村庄。
分析单元
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家庭和个人

总体
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研究总体包括八个参与村庄中所有14-35岁的选定家庭中的个体。
数据类型
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样本调查数据
抽样程序
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所有选定村庄中的家庭均有资格纳入IMAGE研究基线调查。位于村庄边界外的定居点家庭不包括在抽样框架内。每个研究村庄随机选择了200个家庭（总样本量为1600）。在本研究中，家庭被定义为在同一物业（或住宅）上永久居住、在家时共餐的一群人。在选定家庭中，所有在访谈日期时14-35岁的个人均有资格纳入研究。列出的永久家庭成员均有资格纳入，包括那些暂时不在家中的家庭成员。包括拒绝参与和无法追踪的人的调整后总预期样本量为3000。
数据收集方式
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面对面（f2f）
研究工具
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队列研究I：IMAGE对贷款接收者的影响
研究程序：基线：在此阶段，对每个贷款接收者和非贷款接收者进行标准化问卷（资深女性问卷）的访谈。此外，通过访谈（由女性或家庭负责人使用家庭问卷）收集家庭信息。
研究程序：随访：在贷款接收者加入IMAGE两年后，使用上述问卷的改编版对贷款接收者和非贷款接收者进行重新访谈。对所有在基线时注册的女性进行了随访访谈，包括后来退出IMAGE的女性。努力对在随访两年期间搬出家但当时仍可追踪的女性进行了访谈。
队列研究II：IMAGE对贷款接收者家庭中年轻人的影响
研究程序：基线：队列研究II的基线状态与队列研究I相同。尽可能在贷款接收者/非贷款接收者访谈进行后的两个月内对年轻人进行访谈。访谈使用标准化问卷（年轻人问卷）进行。研究招募人员还被要求提供口腔粘膜渗出物（OMT）样本，使用专门设计的收集装置检测HIV抗体。
研究程序：随访：在年轻人加入研究两年后进行随访访谈，使用修改后的年轻人问卷。在此期间还收集了重复的OMT样本。
队列研究III：IMAGE对社区的影响
研究程序：基线：在IMAGE在干预村庄提供之前的三个月内，对全部村庄进行了调查。在所有选定家庭中完成了家庭问卷和年轻人问卷。研究招募人员还被要求提供口腔粘膜渗出物（OMT）样本，使用专门设计的收集装置检测HIV抗体。
研究程序：随访：在基线调查中访谈的家庭和个人在IMAGE在干预村庄推出三年后进行的最终调查中进行了重新访谈。在此期间还收集了重复的OMT样本。