Retention in HIV Care Among Female Sex Workers in the Dominican Republic: Implications for Research, Policy and Programming

Zulliger, Rose; Maulsby, Cathy; Barrington, Clare; Holtgrave, David R.; Donastorg, Yeycy; Pérez, Martha; Kerrigan, Deanna

doi:10.1007/s10461-014-0979-5

Cited by 25 publications

(14 citation statements)

References 27 publications

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“…In our review, FSW highlighted that stigma and discrimination specifically within the healthcare setting were significant barriers to their engagement in care and treatment, which is likely due to their sex work practices and HIV status combined (Logie et al, 2011; USAID, 2013). Interventions focused on healthcare service providers to reduce stigma and discrimination, such as sex work sensitisation training, are urgently needed to improve HIV care and treatment outcomes for FSW, a finding that has been highlighted in other studies (Zulliger et al, 2015). …”

Section: Discussionmentioning

confidence: 99%

HIV care and treatment experiences among female sex workers living with HIV in sub-Saharan Africa: A systematic review

Lancaster

Cernigliaro

Zulliger

et al. 2016

African Journal of AIDS Research

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Female sex workers (FSW) living with HIV in sub-Saharan Africa have poor engagement to HIV care and treatment. Understanding the HIV care and treatment engagement experiences of FSW has important implications for interventions to enhance care and treatment outcomes. We conducted a systematic review to examine the HIV care experiences and determinants of linkage and retention in care, antiretroviral therapy (ART) initiation, and ART adherence and viral suppression among FSW living with HIV in sub-Saharan Africa. The databases PubMed, Embase, Web of Science, SCOPUS, CINAHL, Global Health, Psycinfo, Sociological Abstracts, and Popline were searched for variations of search terms related to sex work and HIV care and treatment among sub-Saharan African populations. Ten peer-reviewed articles published between January 2000 and August 2015 met inclusion criteria and were included in this review. Despite expanded ART access, FSW in sub-Saharan Africa have sub-optimal HIV care and treatment engagement outcomes. Stigma, discrimination, poor nutrition, food insecurity, and substance use were commonly reported and associated with poor linkage to care, retention in care, and ART initiation. Included studies suggest that interventions with FSW should focus on multilevel barriers to engagement in HIV care and treatment and explore the involvement of social support from intimate male partners. Our results emphasise several critical points of intervention for FSW living with HIV, which are urgently needed to enhance linkage to HIV care, retention in care, and treatment initiation, particularly where the HIV prevalence among FSW is greatest.

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Section: Discussionmentioning

confidence: 99%

HIV care and treatment experiences among female sex workers living with HIV in sub-Saharan Africa: A systematic review

Lancaster

Cernigliaro

Zulliger

et al. 2016

African Journal of AIDS Research

Self Cite

100

View full text Add to dashboard Cite

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“…Additional independent factors included internalized sex work stigma, social cohesion, as well as socio-demographic and work environment characteristics. Internalized sex work stigma, which refers to FSWs’ acceptance of the negative attitudes society holds about them, was measured using a reliable (α=0.86) and valid (32) 13-item scale adapted from an internalized HIV stigma measure informed by the work of Berger (33). The same questions asked in the HIV self-stigma measure were re-worded in relation to sex work.…”

Section: Methodsmentioning

confidence: 99%

Adapting the Risk Environment Framework to Understand Substance Use, Gender-Based Violence, and HIV Risk Behaviors Among Female Sex Workers in Tanzania

et al. 2018

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Female sex workers (FSWs) in sub-Saharan Africa are disproportionately affected by HIV and gender-based violence (GBV). Substance use overlaps with these co-occurring epidemics to further increase FSWs' risk for negative health outcomes. We explored the relationship between substance use, GBV, and consistent condom use utilizing baseline data from a cohort of 496 FSWs in Tanzania. Results demonstrate high levels of alcohol use and GBV, and low levels of consistent condom use. Frequent intoxication during sex work was associated with increased odds of recent GBV (aOR 1.64, 95% CI 1.07, 2.49; p value 0.02) and reduced odds of consistent condom use with clients (aOR 0.58, 95% CI 0.37, 0.92; p-value 0.02). We adapt the risk environment framework to contextualize our findings in the social and structural context and to gain insight into intervention approaches to address the intersecting challenges of substance use, GBV, and HIV among FSWs in Tanzania and similar settings.

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“…This scale was validated among FSWs in the Dominican Republic. 43 Exploratory factor analysis was performed on these 13 indicators, suggesting that all indicators loaded highly on a single factor with high reliability (α=0.86). Scale scores ranged from 1 to 40, with higher scores signifying greater sex work-related stigma.…”

Section: Methodsmentioning

confidence: 99%

Work-related mobility and experiences of gender-based violence among female sex workers in Iringa, Tanzania: a cross-sectional analysis of baseline data from Project Shikamana

et al. 2018

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ObjectivesTo examine how work-related mobility among female sex workers (FSWs) is associated with gender-based violence (GBV) in Iringa, Tanzania.DesignCross-sectional analyses were conducted on baseline data gathered between October 2015 and April 2016 from FSWs participating in Project Shikamana, a community empowerment-based combination HIV prevention intervention.SettingParticipants were recruited for the baseline study using venue-based time-location sampling in two communities in Iringa, Tanzania.ParticipantsFSWs were eligible for participation if they were 18 years or older and had exchanged sex for money within the past month. Four-hundred ninety-six FSWs participated in the baseline survey.Primary and secondary outcome measuresAny recent experience of GBV was examined by recent work-related mobility among FSWs. Any recent experience of GBV was also disaggregated by severity for analyses. All bivariate and multivariate binary and multinomial logistic regressions adjusted for intraclass correlations among women recruited from the same venues.ResultsForty per cent of participants experienced recent physical or sexual violence, and 30% recently experienced severe physical or sexual violence. Thirty-three per cent of participants recently exchanged sex for money outside of their district or region, and 12% were both intraregionally and inter-regionally mobile for sex work. Intraregionally and inter-regionally mobile FSWs had 1.9 times greater odds of reporting recent GBV (adjusted OR: 1.89; 95% CI: 1.06 to 3.38; p=0.031) compared with non-mobile FSWs and a 2.5 times higher relative risk for recent experience of severe GBV relative to no recent GBV (relative risk ratio: 2.51; 95% CI: 1.33 to 4.74; p=0.005).ConclusionsMobility for sex work may increase FSWs’ exposure to GBV, particularly more severe GBV. The vulnerability of mobile FSWs to violence, particularly severe forms, demands inclusive services that are accessible to mobile FSWs.

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Retention in HIV Care Among Female Sex Workers in the Dominican Republic: Implications for Research, Policy and Programming

Cited by 25 publications

References 27 publications

HIV care and treatment experiences among female sex workers living with HIV in sub-Saharan Africa: A systematic review

HIV care and treatment experiences among female sex workers living with HIV in sub-Saharan Africa: A systematic review

Adapting the Risk Environment Framework to Understand Substance Use, Gender-Based Violence, and HIV Risk Behaviors Among Female Sex Workers in Tanzania

Work-related mobility and experiences of gender-based violence among female sex workers in Iringa, Tanzania: a cross-sectional analysis of baseline data from Project Shikamana

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