Instituto Dermatologico Y Cirugia Of La Piel

Santo Domingo, Dominican Republic

Instituto Dermatologico Y Cirugia Of La Piel

Santo Domingo, Dominican Republic
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Zulliger R.,Johns Hopkins University | Kennedy C.,Johns Hopkins University | Barrington C.,University of North Carolina at Chapel Hill | Perez M.,Instituto Dermatologico Y Cirugia Of La Piel | And 2 more authors.
Global Public Health | Year: 2017

Female sex workers (FSWs) are disproportionately affected by HIV, but there is limited research on their HIV care experiences. This study explored the experiences of 44 FSWs living with HIV in Santo Domingo, Dominican Republic along the HIV care continuum using in-depth interviews and focus groups. Data were analysed through narrative and thematic analysis. Individual-level factors that facilitated engagement in HIV care were physical and mental health. At the interpersonal level, disclosure of HIV or sex work status and receipt of emotional and economic support were important influences on engagement. Yet, negative reactions to or lack of disclosure of these statuses compromised engagement, further highlighting the role of stigma and discrimination. At the environmental level, FSWs described considerable challenges with the health system including long waits and treatment stock-outs at their clinics, but were generally satisfied with HIV clinic staff. At the structural level, lack of economic resources complicated care and treatment adherence. Findings underscore the need for psychosocial and economic support tailored to the unique needs of FSWs to maximise the individual and public health benefits of HIV care. © 2017 Informa UK Limited, trading as Taylor & Francis Group


Barrington C.,University of North Carolina at Chapel Hill | Donastorg Y.,Instituto Dermatologico Y Cirugia Of La Piel | Perez M.,Instituto Dermatologico Y Cirugia Of La Piel | Galai N.,Haifa University
AIDS and Behavior | Year: 2016

Female sex workers (FSW) are disproportionately affected by HIV. Yet, few interventions address the needs of FSW living with HIV. We developed a multi-level intervention, Abriendo Puertas (Opening Doors), and assessed its feasibility and effectiveness among a cohort of 250 FSW living with HIV in the Dominican Republic. We conducted socio-behavioral surveys and sexually transmitted infection and viral load testing at baseline and 10-month follow-up. We assessed changes in protected sex and adherence to antiretroviral therapy (ART) with logistic regression using generalized estimating equations. Significant pre-post intervention changes were documented for adherence (72–89 %; p < 0.001) and protected sex (71–81 %; p < 0.002). Higher intervention exposure was significantly associated with changes in adherence (AOR 2.42; 95 % CI 1.23–4.51) and protected sex (AOR 1.76; 95 % CI 1.09–2.84). Illicit drug use was negatively associated with both ART adherence and protected sex. Abriendo Puertas is feasible and effective in improving behavioral HIV outcomes in FSW living with HIV. © 2016 Springer Science+Business Media New York

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