Abriendo Puertas

Baseline findings from an integrated intervention to promote prevention, treatment and care among FSW living with HIV in the Dominican Republic

Yeycy Donastorg, Clare Barrington, Martha Perez, Deanna Kerrigan

Research output: Contribution to journalArticle

Abstract

Female sex workers (FSW) are often the focus of primary HIV prevention efforts. However, little attention has been paid to the prevention, treatment, and care needs of FSW living with HIV. Based on formative research, we developed an integrated model to promote prevention and care for FSW living with HIV in Santo Domingo, Dominican Republic, including (1) individual counseling and education; (2) peer navigation; (3) clinical provider training; and (4) community mobilization. We enrolled 268 FSW living with HIV into the intervention and conducted socio-behavioral surveys, sexually transmitted infection (STI) testing, and viral load (VL) assessments. We used multivariate logistic regression to identify behavioral and socio-demographic factors associated with detectable VL (>50 copies/mL) and STI prevalence. Over half of all participants (51.9%) had a detectable VL, even though most received HIV-related care in the last 6 months (85.1%) and were currently on anti-retroviral treatment (ART) (72.4%). Factors positively associated with a detectable VL included being 18-35 years of age (Adjusted Odds Ratio [AOR] 2.46, 95% CI 1.31-4.60), having ever used drugs (AOR 2.34, 95% CI 1.14-4.79), and having ever interrupted ART (AOR 3.09, 95% CI 1.44-6.59). Factors protective against having a detectable VL included being single (AOR 0.45, 95% 0.20-0.98) and being currently on ART (AOR 0.17, 95% CI 0.07-0.41). Nearly one-quarter (23.1%) had an STI, which was associated with being single (AOR 3.21, 95% CI 1.27-8.11) and using drugs in the last 6 months (AOR 3.54, 95% CI 1.32-9.45). Being on ART was protective against STI (AOR 0.51, 95% CI 0.26-1.00). Baseline findings indicate significant barriers to VL suppression and STI prevention among FSW living with HIV and highlight gaps in the continuum of HIV care and treatment. These findings have important implications for both the individual health of FSW and population-level HIV transmission dynamics.

Original languageEnglish (US)
Article numbere88157
JournalPLoS One
Volume9
Issue number2
DOIs
StatePublished - Feb 14 2014

Fingerprint

Dominican Republic
Sex Workers
odds ratio
sexually transmitted diseases
viral load
Viral Load
Odds Ratio
HIV
Sexually Transmitted Diseases
gender
Pharmaceutical Preparations
Logistics
Navigation
Education
Health
Testing
Therapeutics
drugs
Continuity of Patient Care
counseling

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Abriendo Puertas : Baseline findings from an integrated intervention to promote prevention, treatment and care among FSW living with HIV in the Dominican Republic. / Donastorg, Yeycy; Barrington, Clare; Perez, Martha; Kerrigan, Deanna.

In: PLoS One, Vol. 9, No. 2, e88157, 14.02.2014.

Research output: Contribution to journalArticle

@article{b80eb41d54db4c3391387cdbd73b11d9,
title = "Abriendo Puertas: Baseline findings from an integrated intervention to promote prevention, treatment and care among FSW living with HIV in the Dominican Republic",
abstract = "Female sex workers (FSW) are often the focus of primary HIV prevention efforts. However, little attention has been paid to the prevention, treatment, and care needs of FSW living with HIV. Based on formative research, we developed an integrated model to promote prevention and care for FSW living with HIV in Santo Domingo, Dominican Republic, including (1) individual counseling and education; (2) peer navigation; (3) clinical provider training; and (4) community mobilization. We enrolled 268 FSW living with HIV into the intervention and conducted socio-behavioral surveys, sexually transmitted infection (STI) testing, and viral load (VL) assessments. We used multivariate logistic regression to identify behavioral and socio-demographic factors associated with detectable VL (>50 copies/mL) and STI prevalence. Over half of all participants (51.9{\%}) had a detectable VL, even though most received HIV-related care in the last 6 months (85.1{\%}) and were currently on anti-retroviral treatment (ART) (72.4{\%}). Factors positively associated with a detectable VL included being 18-35 years of age (Adjusted Odds Ratio [AOR] 2.46, 95{\%} CI 1.31-4.60), having ever used drugs (AOR 2.34, 95{\%} CI 1.14-4.79), and having ever interrupted ART (AOR 3.09, 95{\%} CI 1.44-6.59). Factors protective against having a detectable VL included being single (AOR 0.45, 95{\%} 0.20-0.98) and being currently on ART (AOR 0.17, 95{\%} CI 0.07-0.41). Nearly one-quarter (23.1{\%}) had an STI, which was associated with being single (AOR 3.21, 95{\%} CI 1.27-8.11) and using drugs in the last 6 months (AOR 3.54, 95{\%} CI 1.32-9.45). Being on ART was protective against STI (AOR 0.51, 95{\%} CI 0.26-1.00). Baseline findings indicate significant barriers to VL suppression and STI prevention among FSW living with HIV and highlight gaps in the continuum of HIV care and treatment. These findings have important implications for both the individual health of FSW and population-level HIV transmission dynamics.",
author = "Yeycy Donastorg and Clare Barrington and Martha Perez and Deanna Kerrigan",
year = "2014",
month = "2",
day = "14",
doi = "10.1371/journal.pone.0088157",
language = "English (US)",
volume = "9",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "2",

}

TY - JOUR

T1 - Abriendo Puertas

T2 - Baseline findings from an integrated intervention to promote prevention, treatment and care among FSW living with HIV in the Dominican Republic

AU - Donastorg, Yeycy

AU - Barrington, Clare

AU - Perez, Martha

AU - Kerrigan, Deanna

PY - 2014/2/14

Y1 - 2014/2/14

N2 - Female sex workers (FSW) are often the focus of primary HIV prevention efforts. However, little attention has been paid to the prevention, treatment, and care needs of FSW living with HIV. Based on formative research, we developed an integrated model to promote prevention and care for FSW living with HIV in Santo Domingo, Dominican Republic, including (1) individual counseling and education; (2) peer navigation; (3) clinical provider training; and (4) community mobilization. We enrolled 268 FSW living with HIV into the intervention and conducted socio-behavioral surveys, sexually transmitted infection (STI) testing, and viral load (VL) assessments. We used multivariate logistic regression to identify behavioral and socio-demographic factors associated with detectable VL (>50 copies/mL) and STI prevalence. Over half of all participants (51.9%) had a detectable VL, even though most received HIV-related care in the last 6 months (85.1%) and were currently on anti-retroviral treatment (ART) (72.4%). Factors positively associated with a detectable VL included being 18-35 years of age (Adjusted Odds Ratio [AOR] 2.46, 95% CI 1.31-4.60), having ever used drugs (AOR 2.34, 95% CI 1.14-4.79), and having ever interrupted ART (AOR 3.09, 95% CI 1.44-6.59). Factors protective against having a detectable VL included being single (AOR 0.45, 95% 0.20-0.98) and being currently on ART (AOR 0.17, 95% CI 0.07-0.41). Nearly one-quarter (23.1%) had an STI, which was associated with being single (AOR 3.21, 95% CI 1.27-8.11) and using drugs in the last 6 months (AOR 3.54, 95% CI 1.32-9.45). Being on ART was protective against STI (AOR 0.51, 95% CI 0.26-1.00). Baseline findings indicate significant barriers to VL suppression and STI prevention among FSW living with HIV and highlight gaps in the continuum of HIV care and treatment. These findings have important implications for both the individual health of FSW and population-level HIV transmission dynamics.

AB - Female sex workers (FSW) are often the focus of primary HIV prevention efforts. However, little attention has been paid to the prevention, treatment, and care needs of FSW living with HIV. Based on formative research, we developed an integrated model to promote prevention and care for FSW living with HIV in Santo Domingo, Dominican Republic, including (1) individual counseling and education; (2) peer navigation; (3) clinical provider training; and (4) community mobilization. We enrolled 268 FSW living with HIV into the intervention and conducted socio-behavioral surveys, sexually transmitted infection (STI) testing, and viral load (VL) assessments. We used multivariate logistic regression to identify behavioral and socio-demographic factors associated with detectable VL (>50 copies/mL) and STI prevalence. Over half of all participants (51.9%) had a detectable VL, even though most received HIV-related care in the last 6 months (85.1%) and were currently on anti-retroviral treatment (ART) (72.4%). Factors positively associated with a detectable VL included being 18-35 years of age (Adjusted Odds Ratio [AOR] 2.46, 95% CI 1.31-4.60), having ever used drugs (AOR 2.34, 95% CI 1.14-4.79), and having ever interrupted ART (AOR 3.09, 95% CI 1.44-6.59). Factors protective against having a detectable VL included being single (AOR 0.45, 95% 0.20-0.98) and being currently on ART (AOR 0.17, 95% CI 0.07-0.41). Nearly one-quarter (23.1%) had an STI, which was associated with being single (AOR 3.21, 95% CI 1.27-8.11) and using drugs in the last 6 months (AOR 3.54, 95% CI 1.32-9.45). Being on ART was protective against STI (AOR 0.51, 95% CI 0.26-1.00). Baseline findings indicate significant barriers to VL suppression and STI prevention among FSW living with HIV and highlight gaps in the continuum of HIV care and treatment. These findings have important implications for both the individual health of FSW and population-level HIV transmission dynamics.

UR - http://www.scopus.com/inward/record.url?scp=84895824285&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895824285&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0088157

DO - 10.1371/journal.pone.0088157

M3 - Article

VL - 9

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 2

M1 - e88157

ER -