Trajectories of HIV Management among Virally Suppressed and Unsuppressed Female Sex Workers in the Dominican Republic: A Comparative Qualitative Analysis

Citation

Savage, Virginia; Gomez, Hoisex; Perez, Martha; Donastorg, Yeycy A.; Kerrigan, Deanna L.; & Barrington, Clare (2023). Trajectories of HIV Management among Virally Suppressed and Unsuppressed Female Sex Workers in the Dominican Republic: A Comparative Qualitative Analysis. International Journal of Qualitative Studies on Health and Well-Being, 18(1), 2164947. PMCID: PMC9869989

Abstract

PURPOSE: Despite suboptimal HIV outcomes among female sex workers (FSW), limited research has been conducted on factors that impact viral suppression among this population. Examining narratives of HIV management, we examined how experiences of diagnosis, treatment initiation, and ongoing care behaviours shaped viral suppression outcomes over time.
METHODS: We conducted 20 in-depth interviews with FSW in Santo Domingo, Dominican Republic. Using narrative and thematic qualitative approaches, we developed analytic summaries and matrices to compare trajectories of managing HIV between suppressed and unsuppressed participants.
RESULTS: Regardless of suppression status, participants described similar narratives of overcoming initial challenges to HIV management through personal resilience and social support. Unsuppressed participants identified more delays in initiating antiretroviral therapy and more lapses in adherence due to less active acceptance of their HIV status and more persistent experiences of economic hardship and HIV stigma.
CONCLUSIONS: We found that individual, interpersonal and structural factors, including stigma and economic precarity, differentiated trajectories towards viral suppression among FSW indicating the importance of multilevel interventions. Improved access to mental health services and social support could promote greater early acceptance of HIV status and progress towards viral suppression among FSW.

URL

http://dx.doi.org/10.1080/17482631.2023.2164947

Reference Type

Journal Article

Year Published

2023

Journal Title

International Journal of Qualitative Studies on Health and Well-Being

Author(s)

Savage, Virginia
Gomez, Hoisex
Perez, Martha
Donastorg, Yeycy A.
Kerrigan, Deanna L.
Barrington, Clare

Article Type

Regular

PMCID

PMC9869989

Continent/Country

Dominican Republic

Sex/Gender

Women

ORCiD

Barrington - 0000-0001-7802-4051