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

Authors

Clare Barrington, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA. cbarring@email.unc.edu.
Tamar Goldenberg, Department of Public Health Education, University of North Carolina Greensboro, Greensboro, US.
Yeycy Donastorg, HIV Vaccine Research Unit, Instituto Dermatológico y Cirugía de Piel Dr. Huberto Bogaert Díaz, Santo Domingo, Dominican Republic.
Hoisex Gomez, HIV Vaccine Research Unit, Instituto Dermatológico y Cirugía de Piel Dr. Huberto Bogaert Díaz, Santo Domingo, Dominican Republic.
Martha Perez, HIV Vaccine Research Unit, Instituto Dermatológico y Cirugía de Piel Dr. Huberto Bogaert Díaz, Santo Domingo, Dominican Republic.
Deanna Kerrigan, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, US.

Document Type

Journal Article

Publication Date

2-1-2023

Journal

AIDS and behavior

DOI

10.1007/s10461-023-04001-7

Keywords

HIV; Resilience; Sex work; Social determinants; Stigma; Transgender women

Abstract

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.

APA Citation

Barrington, Clare; Goldenberg, Tamar; Donastorg, Yeycy; Gomez, Hoisex; Perez, Martha; and Kerrigan, Deanna, "Stigma and HIV Treatment Outcomes Among Transgender Women Sex Workers in the Dominican Republic" (2023). GW Authored Works. Paper 2478.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2478

Department

Prevention and Community Health