What Works for Women and Girls

11D. Strengthening the Enabling Environment:Promoting Women’s Employment, Income andLivelihood OpportunitiesWomen’s economic dependence on men and unequal access to resources, including land andincome-generating opportunities, increases the likelihood of women and girls engaging in avariety of unsafe sexual behaviors including transactional sex, coerced sex, earlier sexual debut,and multiple sexual partners, and thus increases their risk of becoming infected with HIV(Gillespie and Kadiyala, 2005).A Woman’s Economic Stability Can Enhance Her Ability to Insist on Safer SexMarried women and women in partnerships often accept risky behavior by their partnersdue to the need for economic security. A study in Vietnam in 2004 and 2005, consistingof interviews with 23 husbands and 23 wives, along with 15 key informant interviews foundthat because women needed the economic benefits of marriage, women acquiesced to theirhusband’s multiple partnerships or purchasing sex with sex workers. Independent sources ofincome and employment for women may allow women to insist on safe sex (Phinney, 2008).Similarly, a qualitative study in Brazil among women with children enrolled in a day carecenter found that financial dependence is the factor that most contributes to accepting a man’smultiple sexual partnerships. As one woman put it: “She accepts his infidelity because ...she’sthinking...How will I care for the children? How will I find a job?” (Hebling and Guimaraes,2004: 1215). The authors point out: “The results show that although women know how theyshould prevent...AIDS—by using condoms—they feelpowerless to do so, since they feel that this depends on theman’s wishes. They admitted that they don’t have the realdecision power...where ‘the man always has the final word.’Fear of separation was associated with loss of financial…stability” (Hebling and Guimaraes, 2004: 1216). A study inSouth Africa found that the women interviewed claimedthat if they had jobs, they would be able to refuse sex to menwho refused to wear condoms. The women said, “Povertymakes prostitutes of us” (Susser and Stein, 2000: 1044).In certain circumstances, providing microfinancefor women can reduce unsafe sex (Pronyk et al., 2008).Although there is a need for better indicators to measurethe HIV/AIDS-related impact of economic empowerment“The owners of the fi sh nets aremen. The woman comes to thisman who says ‘You want somefi sh, give me sex.’ The womanhas to feed her family, so shecan’t say no.”—Malawian man (Kathewera-Banda et al., 2006: 655)on women and girls, studies have consistently shown that increasing women’s access to information,skills, technologies, services, social support, and income increased their ability toprotect themselves from HIV (Weiss et al., 1996 cited in Weiss and Gupta, 1998; Kaufman etal., 2002).WHAT WORKS FOR WOMEN AND GIRLS317