Economic empowerment and AIDS-related stigma in rural Kenya: a double-edged sword?

Abstract

Economic empowerment, HIV risk and AIDS-related stigma appear intricately intertwined for women in Kenya. Their interaction must be understood in order to implement effective economic interventions that also decrease HIV risk and stigma. We conducted a qualitative study amongst women in a rural Kamba-speaking community of southeastern Kenya to pursue whether engagement in an economic empowerment initiative (a basket weaving cooperative) influences women's perspectives and experiences with HIV risk and AIDS-related stigma. We conducted seven women's focus groups: participants in the local basket-weaving cooperative comprised four focus groups and non-participants comprised the remaining three groups. The HIV status of the women was not known. Three dominant themes emerged from the focus groups: empowerment, pervasive vulnerability and unanticipated social paradoxes. Contradictions found in these themes suggest that economic empowerment can become a double-edged sword. Economic empowerment enhanced perceived individual, domestic and social community status. However, this enhancement was not protective of domestic violence and perceived HIV risk. Social perceptions may have paradoxically contributed barriers to HIV testing and treatment putting women at greater HIV risk. In conclusion, economic empowerment initiatives for women in developing countries in the context of the HIV epidemic should be coupled with peer mediated support and HIV-risk education.

Financial obligations and economic barriers to antiretroviral therapy experienced by HIV-positive women who participated in a job-creation programme in northern Uganda

“…Upon enrollment in the programme, women experienced significant increases in economic attainment, followed by improved social status - participants sent their children to higher quality schools, bought luxury items, and ate meat on a semi-regular basis (for similar findings, see Gnauck et al 2013; Pronyk, Hargreaves, and Morduch 2007). We found that increased economic attainment fundamentally shifted expectations between participants and their social networks so that participants felt obligated to care for extended family members.…”

Economic strengthening for HIV prevention and risk reduction: a review of the evidence

“…A small study of drug-using FSW in the United States found positive associations between a combined risk reduction and IGA intervention and several risk reduction outcomes (Sherman, German, Cheng, Marks, & Bailey-Kloche, 2006). A qualitative study with an adult female population in Kenya reported that participation in an IGA was not protective against HIV risks, including IPV (Gnauck et al, 2013). A final qualitative study with an HIV-positive adult population in Kenya found an IGA plus an in-kind loan for farming inputs reduced behaviors associated with onward transmission of HIV (Zakaras et al, 2016).…”

Economic strengthening for HIV testing and linkage to care: a review of the evidence

“…Only one qualitative study in Kenya evaluated involvement in an income generating activity (IGA) and HTS (Table 5). It found that being a member of a basket weaving cooperative likely created barriers to HTS as members' higher social status was associated with a perception of greater consequences for HIV disclosure and more concern over HIV-related stigma (Gnauck et al, 2013). No studies assessed IGAs and linkage to care.…”