Findings advance the HIV prevention repertoire for women, demonstrating that risk reduction may be achieved through a structural intervention that relies on asset building, including savings, and alternatives to income from sex work.

This study examined the efficacy of an enhanced intervention to reduce sexual risk of HIV/STI and harmful alcohol use among female sex workers in Mongolia. Women (n = 166) were recruited and randomized to either (1) a relationship-based HIV sexual risk reduction intervention; (2) the same sexual risk reduction intervention plus motivational interviewing; or (3) a control condition focused on wellness promotion. At three and six month follow-up, both treatment interventions and the wellness promotion condition were effective in reducing the percentage and the number of unprotected acts of vaginal sex with paying partners in the past 90 days. All three conditions demonstrated efficacy in reducing harmful alcohol use. No significant differences in effects were observed between conditions. Findings suggest that even low impact behavioral interventions can achieve considerable reductions of HIV/STI risk and harmful alcohol use with a highly vulnerable population in a low resourced setting.

Introduction:This article provides an overview of the financial lives of women (n = 204) engaging in sex work in Ulaanbaatar, Mongolia.Methods:This paper presents findings from a computer-based, interviewer-administered baseline assessment administered with women recruited for participation in a randomized controlled trial testing the feasibility of a combined HIV risk reduction and savings-led microfinance intervention for women engaging in sex work in Mongolia.Findings:Findings demonstrate that most women are the primary financial providers for their households, using an array of earning strategies to provide for themselves and other dependents, with sex work often constituting the primary household income source. Financial instability in the lives of people engaging in sex work may increase their risk for HIV and STIs due to a compromised ability to negotiate safer sex with partners in times of economic crisis or need. High levels of financial responsibility for household welfare, when combined with low reported savings, the presence of debt, higher premiums offered for sex without a condom, and high levels of harmful alcohol use, may heighten women's risk for HIV and other STIs.Conclusion:Further research that documents the financial lives of people working in sex work is needed in order to understand the complex relationship between financial stability and engagement in sex work, and to inform the development and testing of structural HIV prevention interventions which target the economic determinants of risk. These findings highlight the importance of economic support programming for women engaged in sex work in Mongolia at a time of rapid economic change in Mongolia.

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