Countering Stigma Improved Savings and Health Among Kolkata Sex Workers

Why This Study?

Stigma and social exclusion can shape how marginalized people see themselves and the choices they make. Anandi Mani, Sayantan Ghosal, Smarajit Jana, Sandip Mitra, and Sanchari Roy test whether a psychological intervention that targets internalized stigma can produce lasting changes in economic and health behaviour among sex workers in Kolkata.

Where and Who?

The study was conducted inside brothels in Kolkata, India, with sex workers who face severe economic marginalization and social stigma. The setting allows examination of how self-image interventions operate among a highly vulnerable population often excluded from mainstream services and policy attention.

What the Intervention Was

The researchers implemented a purely psychological intervention designed to mitigate the adverse effects of internalized stigma — that is, the negative beliefs and lowered self-worth that people adopt when repeatedly treated as socially inferior. The treatment did not involve material transfers or direct cash incentives; it focused on changing how participants perceived themselves.

Methods and Measures

The team used a randomized field experiment to assign participants to the psychological intervention or to a comparison condition, then tracked outcomes over time. Key outcomes included self-image measures, household savings behavior, and preventive health choices. Follow-up data were collected for over a year to assess persistence of effects.

Key Findings

• The intervention produced significant improvements in participants' self-image.
• Treated participants increased their savings and were more likely to adopt preventive health behaviours.
• Behavioural changes persisted: improvements in savings were detectable up to 15 months after the intervention, and health behaviour changes persisted up to 21 months.

Why It Matters

These results show that non-material, psychologically grounded interventions can change economically meaningful behaviours among marginalized groups. For policymakers and practitioners working on poverty alleviation, public health, and social inclusion, the study suggests that addressing internalized stigma may be a cost-effective complement to financial or medical programs when seeking durable behaviour change.