Microfinance Participation and HIV Literacy in Bangladesh: Results from a Nationally Representative Study

 

Purpose: Although developed primarily as an anti-poverty tool, microfinance has been found to impact social and health indicators in several global contexts. Because microfinance emphasizes building relationships and social capital through participation in micro-credit group meetings and interactions with microfinance outreach workers, some scholars have suggested that microfinance may provide an ideal venue for promoting health literacy related to HIV/AIDS and other diseases, in addition to the potential for microfinance to address poverty as a structural driver of HIV/AIDS. The objective of this study was to assess the relationship between microfinance participation and HIV/AIDS literacy in Bangladesh.  Bangladesh has a considerable microfinance infrastructure that primarily targets women, with more than 30 million women currently participating in microfinance initiatives. We hypothesized that microfinance participation would be associated with greater levels of HIV literacy for Bangladeshi women.

Methods: This study used data from the nationally representative Bangladesh Demographic and Health Survey 2011.  Our analyses were based on responses of 3,166 currently married women age 15-49. Logistic regression analysis using survey techniques was conducted to assess the binary outcome of HIV literacy, a dichotomous measure based on participants’ responses to four true-or-false statements about HIV transmission (e.g. “a normal looking person can have HIV” or “HIV can be transmitted by sharing food”). Participants who correctly responded to all four items were classified as HIV literate. Predictor variables in the multivariate model were microfinance participation, measured by a dichotomous variable indicating whether women participated in any of the five major microfinance organizations in Bangladesh, as well as control variables including wealth assets, media exposure, and demographic characteristics (age, education, employment, husband’s HIV literacy, and geographic location).

Results: Approximately 68% (n=2,530) of the study population were HIV literate and 30% (n=1,080) participated in microfinance. Multivariate analyses indicated a moderate effect for microfinance participation on HIV literacy (OR =1.3; 95% CI: 1.1-1.6) when controlling for the other covariates in the model. Several of the control variables were also significant, with higher levels of education, media exposure, and husband’s HIV literacy being associated with greater likelihood of HIV literacy for the sample.

Implications: Results support the study hypothesis, indicating that married women who participate in microfinance in Bangladesh are more likely to be HIV literate, after controlling for other predictors of HIV literacy. The HIV epidemic in Bangladesh is currently concentrated among high-risk groups including injection drug users and female sex workers and their clientele. However, the female partners of men in these risk groups have been identified as a key “bridging population” who must be educated about HIV in order to prevent the epidemic from spreading further into the general population. This study’s findings suggest that integrating HIV education into microfinance programs may be an effective and efficient means of promoting HIV literacy among Bangladeshi women. Further international social work intervention research should examine specific strategies for combining HIV education and microfinance and the impact of these strategies on HIV prevention and other health and social outcomes.