Innovative economic enhancement and HIV-prevention intervention study

Researchers from the Johns Hopkins Bloomberg School of Public Health have found a new way to address HIV and sexual risk taking among drug-using women involved in prostitution.

The Jewelry Education for Women Empowering their Lives (JEWEL) program introduced 55 drug-using women to HIV risk prevention and the making, marketing and selling of beaded jewelry. After participating in the program, the women reduced their number of sex partners, spent less on drugs daily and decreased crack use. The study is published in the January 2006 issue of AIDS Care.

"Because so much of women drug users' HIV risks are economically motivated, providing them with licit options for income effectively reduces their risk," said Susan G. Sherman, PhD, MPH, lead author of the study and an assistant professor in the Department of Epidemiology at the Bloomberg School of Public Health.

For this pilot study, the authors targeted women using illegal drugs who were involved in prostitution in Baltimore, Md. They implemented six two-hour sessions to teach not only HIV-prevention risk reduction but also the making, marketing and selling of jewelry. The women sold the handmade jewelry at 11 public sales and earned more than $7,000.

Three months after participating in the study, the women reported a 29 percent reduction in receiving drugs or money for sex and a 33 percent reduction in the number of sex -trade partners per month. The study authors also noticed a reduction in the amount of money spent on drugs each day and a decrease in daily crack usage.

"This program didn't just reduce HIV risk; it increased the women's self esteem. Most of them have been selling themselves for so long, and giving them the opportunity to sell a beautiful product that other people appreciate really had an impact on their self value as well. This program is a novel approach to self empowerment and HIV-prevention," said Sherman.

The effects of JEWEL continued past the end of the one-year pilot study. The most prolific jewelry-maker in the program continued not only making jewelry but teaching other at-risk women. She and Sherman are in the process of establishing a nonprofit group called GEMS of Hope. The study authors said they hope to conduct a larger, follow-up study of women who use crack in Baltimore, Md.

"The evaluation of the JEWEL project: An innovative economic enhancement and HIV-prevention intervention study targeting drug-using women involved in prostitution" was supported by a grant from the National Institute on Drug Abuse.