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We anticipate several challenges in recruitment and retention of participants. FSW who use drugs are highly marginalized, and often hesitant to hunt healthcare and different services for worry of stigma or legal repercussions . Our determination to recruit at subject areas in addition to through a peer-referral system was meant to extend the attain of our examine to as many FSW as possible. However, there’s some proof that shows that network-based recruitment and venue-based recruitment of FSW yields populations with completely different sociodemographic characteristics and even completely different STI prevalence . We purpose to resolve this concern through random project to check situation, and to conduct analyses that contemplate recruitment supply, and any other variations doubtlessly identified between research circumstances, as a moderating variable.

The HIVRR and FLT periods are led by skilled research facilitators, supervised by study staff and investigators. A number of high quality assurance measures have been put into place to ensure standardization throughout sessions and facilitators. Sessions are audio-recorded, and tapes are randomly chosen for evaluate by native medical supervisors and US-based study investigators. Clinical supervisors note adherence to the intervention protocol and handle any areas of immediate concern directly with the facilitators. Team supervision is held as soon as a month with US-primarily based research investigators through Skype calls to debate the challenges confronted by facilitators in conducting the periods and adhering to the protocol. During weeks 3 and four of the intervention interval, the remedy arm solely receives Financial Literacy Training .

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Academic literature on microfinance for HIV-risk reduction has known as for a extra rigorous testing of interventions, examination of the causal pathways between microfinance and lowered danger-conduct outcomes, and the use of biomarkers . Our assessments provide much-wanted information on the experiences, risks and wishes of this inhabitants in Kazakhstan, the variables that reasonable and mediate HIV-risk outcomes, and the way these differ between remedy and management situations. We are the primary research, to our knowledge, to make use of organic testing to supplement self-reported HIV and STI knowledge. Our stringent high quality control measures and using a computerized data assortment tool ensure standardization and consistency among individuals. Ours is the first RCT carried out with FSW in Kazakhstan, and one of the few carried out in Central Asia.

Conversely, she stated, any risk from the federal government during this delicate period, like stern interrogations by police, would work at cross-functions. The male troopers on guard, for instance, are underneath strict orders not to intimidate the ladies. Kazakhstan has sought a larger function in worldwide diplomacy with a variety of initiatives to resolve global issues, including as soon as providing to dispose of different nations’ nuclear waste on its territory. And so far, it’s the solely nation with a big contingent of residents in Syria to conform to repatriate all of them — a complete of 548, so far. So like a scene from a prosecutor’s daydream, a small resort within the desert of western Kazakhstan is filled with these women, whom many governments view as terrorist suspects. Unlike virtually each Western country and most of the rest of the world, Kazakhstan is welcoming residence women like Ms. Sarina — albeit warily and despite the lack of proof that deradicalization programs work — somewhat than arresting them in the event that they dare show up.

Medicine And Health Care

A Data Safety and Monitoring Board , consisting of Kazakhstan-based researchers, has been identified and meets on an annual foundation to evaluate all ongoing research data and human subjects points. Standardized protocols and trainings are used to guarantee consistency and fidelity to the intervention and assessments throughout a number of examine websites. Research assistants, scientific coordinators, and facilitators obtain standard coaching of their areas of duty, including procedural manuals and checklists. The use of CASI for baseline and observe-up behavioral assessments ensures that every participant is receiving the identical version of the questionnaire, and that there isn’t a response bias. Each web site receives day by day supervision from a site coordinator, who’s responsible for reviewing examine data and reporting any irregularities or protocol violations to the examine team.

NE and SW are joint principal investigators on this research and guided general conceptual design for the research and intervention and preparation of the manuscript. AT and SP contributed to the conceptual design, and oversaw study implementation in the area. SB guided the information evaluation plan and energy analyses for sample measurement and drafted the data evaluation section of this manuscript. TM and GM have been project coordinators and drafted examine protocols and measures. AK was a coordinator for the examine and contributed to review protocols.

Microfinance For Women At High Risk For Hiv In Kazakhstan: Study Protocol For A Cluster

Among the process evaluation measures included are intervention session attendance , vocational coaching attendance and matched financial savings deposits and spending , and retention measures. These process measures are used for numerous women of kazakhstan reasons, including supervision, evaluation of standardization and constancy to the intervention, and for use in booster training occasions throughout the study period.

The FLT intervention was adapted from the monetary literacy intervention used within the Undarga examine . FLT periods focus on facilitating access to banking services , household budgeting , short- and lengthy-time period financial savings, debt administration and monetary negotiations. Sessions are designed to extend participant information, skills, and self-efficacy related to managing and controlling finances, which could improve their capacity for financial savings. Participants proceed to build upon the objective-setting abilities that they developed within the HIVRR sessions, and facilitators continue to conduct safety examine-ins. Sessions are held 3 times per week over 2 weeks for a complete of six sessions.

Data management staff on the study group are responsible for coordinating data collection throughout multiple databases. Weekly Skype conferences with examine investigators are used to handle any points or challenges.

Our use of a longitudinal research design, assessing outcomes over a 12-month post-intervention period, allows for us to examine the long-lasting effects of our intervention and assess the sustainability of its outcomes. Our combined-methods method, which incorporates biological assessments, behavioral questionnaires, in-depth interviews, and value information, allows us to evaluate the influence of our intervention on multiple levels. The qualitative component of our examine uses in-depth interviews to probe deeper into the limitations to financial savings and vocational entry skilled by FSW, in addition to providing info on the feasibility and acceptability of the intervention.

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