In Tijuana’s red-light district, thousands of women rely on sex work to survive. A study led by researchers at San Diego State University finds a program that combines economic support and education may help some women improve their health and financial stability.
Researchers followed 120 female sex workers in Tijuana over three years as they participated in a program called ESTIMA, the Spanish word for self-esteem.
Participants received small loans and training to start or expand small businesses, from selling cosmetics and cleaning products to preparing and selling food.
Elizabeth Reed, a professor in the school of public health at San Diego State University and the study’s lead researcher, said the program produced improvements across several areas.
“We found meaningful improvements in financial stability, reduced substance use, increased savings, improved condom negotiation, and greater self-confidence,” Reed said.
The program was implemented by Los Niños de Baja California, a nonprofit that works with vulnerable communities in the border region.
Elisa Sabatini, executive director of Los Niños de Baja California, helped run the program.
“They can run a business and have a different source of income,” Sabatini said. “The second piece is really about their own empowerment and self-worth.”
Participants also receive training on women’s health, nutrition and violence prevention, along with business support.
“The trainings that occur are related to women and violence, nutrition and health education, sort of women's health and then also business support,” Sabatini said.
Researchers said the group setting was also a key part of the program.
“I think what mattered most wasn't just a loan,” Reed said. “It was also the support that women gave each other.”
Many participants had never spoken openly about their work because of stigma.
“I think the groups really created this trusted space where women could talk openly, share strategies and support each other,” Reed said.
Reed said the program had an impact beyond financial assistance.
“For many women, the program wasn't just about money, it was also about dignity, belonging and self-worth,” she said.
Funding for the ESTIMA program ended eight years ago, but Sabatini said it's still continuing.
“The program is now in its 12th year,” she said.
Researchers said the results suggest programs that combine economic opportunity, health education and peer support may help reduce health risks and expand options for women in vulnerable situations.
