Project Nova: A Combination HIV Prevention and Microfinance Intervention for Women Who Engage in Sex Work and Use Drugs in Kazakhstan


Innovative combination HIV-prevention and microfinance interventions are needed to address the high incidence of HIV and other STIs among women who use drugs. Project Nova is a cluster-randomized, controlled trial for drug-using female sex workers in two cities in Kazakhstan. The intervention was adapted from prior interventions for women at high risk for HIV and tailored to meet the needs of female sex workers who use injection or noninjection drugs. We describe the development and implementation of the Nova intervention and detail its components: HIV-risk reduction, financial-literacy training, vocational training, and a matched-savings program. We discuss session-attendance rates, barriers to engagement, challenges that arose during the sessions, and the solutions implemented. Our findings show that it is feasible to implement a combination HIV-prevention and microfinance intervention with highly vulnerable women such as these, and to address implementation challenges successfully.


Existe la necesidad de una intervención innovadora que combine intervenciones de prevención del VIH y microfinanzas para manejar la alta incidencia de VIH u otras enfermedades de transmisión sexual con mujeres que usan drogas. Nova es un Ensayo Clínico Controlado Aleatorio Grupal para mujeres trabajadoras sexuales que usan drogas en dos ciudades en Kazakstán. La intervención fue adaptada de otras intervenciones anteriores dirigidas a mujeres con alto riesgo de contraer VIH y diseñada para satisfacer las necesidades de las mujeres trabajadoras sexuales que se inyectan o consumen drogas. Este documento describe el desarrollo y la implementación de la intervención Nova. Describimos los componentes de la intervención Nova, los cuales incluyen reducción del riesgo de VIH, entrenamiento en conocimiento financiero, entrenamiento vocacional, y programa de ahorros igualados. También describimos las tasas de asistencia a las sesiones, barreras para la participación, desafíos durante la implementación de las sesiones, y las soluciones implementadas. Los resultados muestran que es posible implementar una combinación de intervención de reducción del riesgo de VIH y micro-finanzas con mujeres altamente vulnerables y resolver problemas para manejar exitosamente los desafíos de la implementación.

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The authors would like to thank the study participants who shared their time and experiences with Project Nova and the project staff who assisted with recruitment, data collection and project implementation. We would like to thank Republican Center on Prevention and Control of AIDS and Dr. Baiserkin, city AIDS center of Almaty, Temirtau and Karaganda for collaboration. We appreciate assistance in recruitment and support of our study participants of NGO “Moi Dom” and “Shapagat” in Temirtau, NGO “Doverie” in Almaty.


This study was funded by the National Institute on Drug Abuse (NIDA), Grant No. R01 DA036514, to Drs. Nabila El-Bassel and Susan Witte (Multiple PIs). The funders had no involvement in the design of the study or in collection, analysis and interpretation of data.

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Correspondence to Susan S. Witte.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of Columbia University’s IRB and the ethics committee of the Kazakhstan School of Public Health (KSPH), and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in this study.

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Mergenova, G., El-Bassel, N., McCrimmon, T. et al. Project Nova: A Combination HIV Prevention and Microfinance Intervention for Women Who Engage in Sex Work and Use Drugs in Kazakhstan. AIDS Behav 23, 1–14 (2019).

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  • HIV prevention
  • Intervention science
  • Microfinance
  • Sex work
  • Drug use