Microfinance and HIV prevention – emerging lessons from rural South Africa

Action Research Programme (RADAR), School of Public Health, University of the Witwatersrand, South Africa. L.A. Morison is with the Infectious Disease Epidemiology Unit, Department of Infectious and Tropical Diseases, LSHTM (London School of Hygiene and Tropical Medicine), C. Watts is with the Health Policy Unit, Department of Public Health and Policy, LSHTM, and J.D.H. Porter is with the Clinical Research Unit, Department of Infectious and Tropical Diseases, LSHTM. The authors would like to acknowledge the Board, Managing Director and staff of Small Enterprise Foundation (Tzaneen, South Africa) without whose support this collaboration would not have been possible. Financial assistance for this work has been provided by the Enterprise Development Innovation Fund of the Department for International Development (UK), the Henry J. Kaiser Family Foundation, the Ford Foundation and the South African National Department of Health and Welfare. Do the gains in confidence and economic well being that can come from participation in a microfinance programme reduce clients’ vulnerability to HIV infection? Until now practical experience and an evidence base relating to such activities have been limited. This article reviews the evidence supporting an enhanced role for microfinance in HIV prevention activities. It describes the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) – a South African case study that has been specifically designed to explore these relationships. The paper discusses the operational integration of microfinance and HIV prevention – highlighting challenges, emerging lessons and limitations in the light of international best practice and several years of field experience.