Multilevel hiv Prevention to Address the Impact of Labor Migration on Wives

In this paper, studies of Tajik wives documented how male labor migration both increased husband’s mobility and infidelity, and diminished wives’ control over finances, sexuality, and health. Based upon these results, authors have formed an Intervention Design Collaborative (idc) of migrants, wives, community leaders and providers which developed a new hiv prevention model called Healthy Homes. It was designed as a multilevel hiv prevention to reduce hiv risk among wives of migrants by: 1) enhancing wives’ hiv risk awareness, knowledge, and prevention skills; 2) improving wives’ access to hiv/sti care, and; 3) promoting cultural norms and attitudes that enable wives to be more active in protecting themselves and their families from hiv. A pilot study of Healthy Homes was conducted in two Dushanbe primary care clinics. Compared with the controls, the Healthy Homes group reported statistically significant increases in hiv knowledge and worry, communication with spouse and health worker, hiv and sti testing, condom attitudes and use with husband. No increases in family conflict or violence were reported. In conclusion, multilevel hiv prevention centered on wives of seasonal labor migrants is feasible, acceptable, and if effective, could help to halt the current and future growth in hiv among high-risk populations of labor migrants and their families.