Stigma and HIV Treatment Outcomes Among Transgender Women Sex Workers in the Dominican Republic

Trans women experience multiple forms of intersecting stigma due to trans identity, HIV, and sex work, which can negatively affect their health. There is limited understanding of the relationships between stigma and HIV care and treatment outcomes. We assessed associations between multiple forms and...

Full description

Saved in:
Bibliographic Details
Published in:AIDS and behavior 2023-08, Vol.27 (8), p.2774-2784
Main Authors: Barrington, Clare, Goldenberg, Tamar, Donastorg, Yeycy, Gomez, Hoisex, Perez, Martha, Kerrigan, Deanna
Format: Article
Language:English
Subjects:
Antiretroviral therapy
Clinical outcomes
Cross-Sectional Studies
Dominican Republic - epidemiology
Drug abuse
Drug use
Drugs
Female
Health behavior
Health Psychology
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
Infectious Diseases
Medicine
Medicine & Public Health
Original Paper
Prostitution
Public Health
Resilience
Sex industry
Sex Workers
Sexually transmitted diseases
Social Stigma
STD
Stigma
Transgender Persons
Treatment Outcome
Treatment outcomes
Women
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Trans women experience multiple forms of intersecting stigma due to trans identity, HIV, and sex work, which can negatively affect their health. There is limited understanding of the relationships between stigma and HIV care and treatment outcomes. We assessed associations between multiple forms and types of stigma and HIV treatment outcomes among trans women who conduct sex work in Santo Domingo, Dominican Republic using cross-sectional survey data. Most participants had received HIV care (91%) and were currently taking anti-retroviral therapy (ART) (84%). Only 64% were virally suppressed. Nearly one-third (32%) had interrupted ART at some point; those who had never interrupted ART were more likely to be suppressed. Drug use was associated with ART interruption. Higher enacted HIV stigma was associated with current ART use. Higher enacted HIV stigma and higher anticipated sex work stigma were associated with ART adherence. Higher trans stigma was associated with being virally suppressed. Findings highlight the importance of addressing multiple forms of stigma at the individual and clinic levels to improve and sustain viral suppression. Future research is needed to assess if unexpected associations between stigma and HIV outcomes reflect processes of resilience. Future research is also needed to assess the pathways between drug use, ART interruption, and viral suppression among trans women.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-023-04001-7