Issues of poverty, gender inequalities and health intersect, reinforce and perpetuate each other constructing complex barriers to the empowerment of women and girls. The way in which these issues manifest as economic inequalities, HIV infection and intimate partner violence are of significant concern in the South African context.

The ‘Intervention with Microfinance for AIDS and Gender Equity’ (IMAGE) is a complex programme that combines gender and HIV training with group-based microfinance to address issues for wider social change. The microfinance component consisted of loans administered for the development of income generating activities with a group lending model.

The Sisters for Life gender and HIV training programme accompanied loan centre meetings and was structured on the basis of participatory learning and action principles. Phase one worked with women on critical reflection and analysis of gender roles and norms, strengthening communication and leadership skills. Phase two engaged women in wider community mobilisation activities with young people and men. Cross-sectional data were derived from women in three randomly selected matched clusters in rural South Africa, between 2001 and 2005.

Comparative analysis between IMAGE and a microfinance only control intervention showed that although both programmes supported improvements in economic well-being, IMAGE showed associated effects in relation to women’s empowerment, reduced intimate partner violence and HIV protective actions - whilst actual reductions in HIV infections proved impossible to determine.

This research suggests that combining women’s economic empowerment initiatives with interventions that recognise the wider social and political context in which women’s lives are situated have the potential to lead to more sustainable change.