Trajectories of HIV management among virally suppressed and unsuppressed female sex workers in the Dominican Republic: A comparative qualitative analysis.

Content Provider	Europe PMC
Author	Savage, Virginia Gomez, Hoisex Perez, Martha Donastorg, Yeycy Kerrigan, Deanna Barrington, Clare
Copyright Year	2023
Abstract	PurposeDespite suboptimal HIV outcomes among female sex workers (FSW), limited research has been conducted on factors that impact viral suppression among this population. Examining narratives of HIV management, we examined how experiences of diagnosis, treatment initiation, and ongoing care behaviours shaped viral suppression outcomes over time.MethodsWe conducted 20 in-depth interviews with FSW in Santo Domingo, Dominican Republic. Using narrative and thematic qualitative approaches, we developed analytic summaries and matrices to compare trajectories of managing HIV between suppressed and unsuppressed participants.ResultsRegardless of suppression status, participants described similar narratives of overcoming initial challenges to HIV management through personal resilience and social support. Unsuppressed participants identified more delays in initiating antiretroviral therapy and more lapses in adherence due to less active acceptance of their HIV status and more persistent experiences of economic hardship and HIV stigma.ConclusionsWe found that individual, interpersonal and structural factors, including stigma and economic precarity, differentiated trajectories towards viral suppression among FSW indicating the importance of multilevel interventions. Improved access to mental health services and social support could promote greater early acceptance of HIV status and progress towards viral suppression among FSW.
Page Count	1
ISSN	17482623
Journal	International Journal of Qualitative Studies on Health and Well-being
Volume Number	18
PubMed Central reference number	PMC9869989
Issue Number	1
PubMed reference number	36681941
e-ISSN	17482631
DOI	10.1080/17482631.2023.2164947
Language	English
Publisher	Taylor & Francis
Publisher Date	2023-12-01
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Subject Keyword	HIV female sex workers viral suppression Dominican Republic narrative analysis stigma
Content Type	Text
Resource Type	Article
Subject	Health Policy Fundamentals and Skills Issues, Ethics and Legal Aspects Gerontology