ORIGINAL PAPER Effects of Micro-Enterprise Services on HIV Risk Behaviour Among Female Sex Workers in Kenya’s Urban Slums Willis Omondi Odek Æ Joanna Busza Æ Chester N. Morris Æ John Cleland Æ Elizabeth N. Ngugi Æ Alan G. Ferguson Ó Springer Science+Business Media, LLC 2008 Abstract This study assessed individual-level effects of adding micro-enterprise services to a peer-mediated HIV/ AIDS intervention among 227 female sex workers (FSWs) in Kenya. Survey data were collected in May–July 2003 and July–August 2005. Two-thirds of participants had operational businesses by end-line survey. Nearly half reported to have stopped sex work. Self-reported weekly mean number of all sexual partners changed from 3.26 (SD 2.45) at baseline to 1.84 (SD 2.15) at end-line survey (P \ 0.001). Weekly mean number of casual partners did not change significantly. Weekly mean number of regular partners changed from 1.96 (SD 1.86) to 0.73 (SD 0.98) over the follow-up period (P \ 0.001). Consistent condom use with regular partners increased by 18.5% and remained above 90% with casual partners. Micro-enterprise services may empower FSWs by giving them an alternative liveli- hood when they wish to exit or reduce reliance on sex work. Determinants of successful business operation by FSWs deserve further research. Keywords Microfinance Á Kenya Á Female sex workers Á Regular partners Á Sex work Introduction Recent estimates indicate that 7.8% of adults (age 15– 49 years) in Kenya are infected with HIV. While this represents a significant drop from an average prevalence of 10% in the 1990s, large variations still exist between males and females, along age groups and between urban and rural settings. Urban populations in Kenya have higher adult HIV prevalence (10%) than do rural populations (7%). HIV prevalence in females (age 15–49 years) in Kenya is 9.2% in comparison to 5.8% among males in the same age range. The gender gap in HIV prevalence is most pronounced in the 15–24 year age range where females are about four times more likely to be infected with HIV than their male counterparts (NASCOP 2005, 2008; Cheluget et al. 2006; CBS et al. 2004). Many factors influence women’s vulnerability to HIV, including unfavourable social and economic realities (UNAIDS 2000, 2002; Gupta 2002; Sumartojo et al. 2000). More importantly, economic deprivation and dependency pushes some women into high-risk means of livelihood such as transactional sex that exposes them to risks of sexually transmitted infections (STI), including HIV. Even though Kenya’s economic performance improved since 2003 fol- lowing the election of a new government, these effects have not trickled down to ordinary citizens, especially those inhabiting urban slums. Kenya’s real gross domestic product (GDP) growth rose from 2.8% in 2003 to 5.8% in 2005 and to around 6.0% in the subsequent 2 years, but incidence of absolute poverty has remained significant, affecting at least 29% of the urban population (GOK 2007; UNDP 2006). W. O. Odek (&) Á E. N. Ngugi Department of Community Health, University of Nairobi, P.O. Box 1086, City Square 00200, Nairobi, Kenya e-mail: odekw@yahoo.co.uk J. Busza Á J. Cleland Centre for Population Studies, London School of Hygiene and Tropical Medicine, London, UK C. N. Morris Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada A. G. Ferguson Constellafutures, Nairobi, Kenya 123 AIDS Behav DOI 10.1007/s10461-008-9485-y