"You know that we travel a lot": Mobility narratives among female sex workers living with HIV in Tanzania and the Dominican Republic

Zoé M. Hendrickson, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Maria De Jesus, School of International Service, American University, Washington, DC, United States of America.
Clare Barrington, Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America.
S Wilson Cole, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Caitlin E. Kennedy, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Laura Nicole Sisson, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Mudia Uzzi, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Yeycy Donastorg, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic.
Martha Perez, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic.
Hoisex Gomez, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic.
Jessie Mbwambo, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Samuel Likindikoki, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Deanna L. Kerrigan, Prevention and Community Health Department, Milken Institute School of Public Health, the George Washington University, Washington, DC, United States of America.

Document Type

Journal Article

Publication Date

1-1-2024

Journal

PLOS global public health

Volume

4

Issue

7

DOI

10.1371/journal.pgph.0003355

Abstract

Female sex workers (FSW) are highly mobile, which may result in reduced access to and use of health services and increased risk for poor health outcomes, particularly for those living with HIV. Mobility includes spatial, temporal, and social elements that are not fully captured by quantitative measures. We conducted two rounds of in-depth interviews with FSW living with HIV in Iringa, Tanzania (n = 20), and Santo Domingo, Dominican Republic (n = 20), to describe mobility experiences and compare mobility narratives across settings. We integrated a thematic analysis of all interviews with a narrative analysis of a subset of 10 information-rich interviews (five in each country) with women who had recently traveled, for sex work or another reason, outside of their hometown. Across narratives, FSW living with HIV traveled locally or to seasonal destinations, for short and long periods. Social factors influencing mobility included economic drivers; risk of arrest, harassment, or violence; anonymity and/or familiarity; social relationships; and clients' mobility. Spatial, temporal, and social factors intersected in unique ways in FSW's mobility experiences, yet distinct mobility typologies were evident across settings and destinations. Together, mobility narratives of FSW living with HIV can inform quantitative research on mobility typologies in Tanzania, the Dominican Republic, and elsewhere. With the potential for economic circumstances, climate change, and other emergencies to increase people's mobility around the world, researchers and practitioners can learn from the lived experiences of FSW to inform whether and how to tailor and improve the accessibility of HIV care and treatment interventions based on spatial, temporal, and social characteristics of mobility.

Department

Prevention and Community Health

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