Preventing HIV One Bag at a Time

Kalaiselvi, a young mother living in the slums of Chennai, India, used to sell her body to make ends meet. Like many women, she turned to the trade out of desperation: Her husband had squandered the family’s money on alcohol, leaving her and her son without food.

Now, through the Pi Project, a new partnership between the Bloomberg School and an Indian nonprofit, YRG CARE, Kalaiselvi has a new way to make money: by sewing brightly colored cloth bags.

The Pi Project is designed to provide a sustainable, legal source of income for women sex workers. Master tailors train the women to sew tote bags, lunch bags and wine bags. The bags get shipped to the U.S. and sold, with 90 percent of profits returning to the women. The hope is that this training and income—and the HIV prevention classes that go along with it—will not only improve the women’s lives but also lower their risk of contracting HIV. “So much of women’s risk is economically motivated,” says Susan Sherman, PhD, MPH, associate professor in the Department of Epidemiology and the project’s lead researcher. “If you change the economic structure of someone’s life, it has a far-reaching impact.”

YRG CARE, the project’s co-sponsor, is one of the largest private AIDS service providers in India. Suniti Solomon, head and founder of the Chennai-based nonprofit, says that she and her colleagues were looking for a way to help older sex workers. “They compromise their health by having unprotected sex just to get more clients,” she says. “So we offer this entrepreneurship program to them.”

This isn’t the first time Sherman has used microenterprise for HIV prevention. In 2002, she started a pilot project in Baltimore to investigate whether teaching drug-using women involved in the sex trade how to make, market and sell jewelry could reduce their risk of contracting HIV. The women sold more than $7,000 worth of jewelry and reduced their number of sexual partners from a monthly average of nine to three.

“I was always interested in scaling that [project] up,” Sherman says. And YRG CARE took an early interest. So Sherman and her coinvestigator, Bloomberg School epidemiologist David Celentano, ScD ’77, MHS ’75, a longstanding collaborator with YRG CARE, took the basic idea and tailored it for India.

Why bags? (Pi means “bag” in Tamil, the local language). Environmental concerns have led a growing number of Americans to shun plastic bags in favor of reusable ones. “I liked the idea of tying together the notions of women’s empowerment, poverty alleviation, HIV prevention and an eye on the environment. There’s something for everyone,” Sherman explains.

Funded by the National Institute of Mental Health and only a year old, the project is already having an impact. Early results show that women who received training in bag making and HIV prevention earned more money and had fewer sexual partners than women who received HIV prevention training alone. At press time, the project had sold 1,400 bags via the Internet (www.pibags.org) and vendors in Maryland and California.

Katharine Rivett, MPH ’08, MBA, heads the U.S.-based Pi Foundation, which handles marketing, sales and the distribution of the bags. Solomon and Aylur Kailasom Srikrishnan oversee research and operations in India.

For now, the Pi Project is limited to the 50 women who have already been trained. But as new orders roll in, Pi will need more bag makers. The goal is to recruit 250 more women in the next three years. Finding new trainees should not be a problem, Kalaiselvi says. “There are so many women out there who are hoping a new life will come their way.”