Substance Use and Depression Impede ART Adherence Among Female Sex Workers Living with HIV in the Dominican Republic

Authors

Yan Wang, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. yanwang20@gwu.edu.
Tahilin Sanchez Karver, Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Carla J. Berg, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Clare Barrington, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Yeycy Donastorg, HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic.
Martha Perez, HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic.
Hoisex Gomez, HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic.
Wendy Davis, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Noya Galai, Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Deanna Kerrigan, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.

Document Type

Journal Article

Publication Date

12-7-2022

Journal

AIDS and behavior

DOI

10.1007/s10461-022-03940-x

Keywords

ART adherence; Depression; HIV; Sex work; Substance use

Abstract

Female sex workers (FSW) have worse HIV outcomes in part due to lower anti-retroviral therapy (ART) adherence. Substance use and depression are important barriers to ART adherence, yet few studies have assessed these relationships among FSW in longitudinal studies. Cross-Lagged Panel Models and autoregressive mediation analyses assessed substance use (illicit drug use and alcohol use disorders) in relation to ART non-adherence and the mediation role of depressive symptoms among 240 FSW living with HIV in the Dominican Republic. In annual visits (T1, T2, T3), the majority (70%, 66%, and 53%) reported at-risk drinking and 15%, 13% and 9% used illicit drug during the past 6 months. Most FSW (70%, 62% and 46%) had mild-to-severe depression. Illicit drug use predicted later ART non-adherence. This relationship was not mediated via depressive symptoms. Integrated substance use and HIV care interventions are needed to promote ART adherence and viral suppression among FSW.

APA Citation

Wang, Yan; Karver, Tahilin Sanchez; Berg, Carla J.; Barrington, Clare; Donastorg, Yeycy; Perez, Martha; Gomez, Hoisex; Davis, Wendy; Galai, Noya; and Kerrigan, Deanna, "Substance Use and Depression Impede ART Adherence Among Female Sex Workers Living with HIV in the Dominican Republic" (2022). GW Authored Works. Paper 2132.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2132

Department

Prevention and Community Health