‘HIV and work don't go together’: Employment as a social determinant of HIV outcomes among men who have sex with men and transgender women in the Dominican Republic

Clare Barrington, Ramon Acevedo, Yeycy Donastorg, Martha Perez, Deanna Kerrigan

Research output: Contribution to journalArticle

Abstract

Men who have sex with men (MSM) and transgender women are disproportionately affected by HIV in the Dominican Republic. Little is known about their experiences living with HIV as a chronic condition. We explored employment as a social determinant of well-being with HIV. We conducted 42 qualitative in-depth interviews with MSM (n = 16) and transgender women (n = 5) living with HIV; each participant completed 2 interviews to facilitate depth and iterative analysis. We used narrative analysis and systematic coding to identify salient themes related to employment and the HIV experience and developed a conceptual model of the pathways between HIV stigma, unemployment, and HIV outcomes. Early life experiences, including rejection from families and school, resulted in limited work opportunities, especially among transgender women. Following HIV diagnosis, participants across all socio-economic levels lost jobs and/or were unable to get jobs due to illegal HIV testing and HIV stigma and discrimination. Not being able to work impacted mental health, engagement in HIV care, and overall well-being. We conclude that lack of employment is a salient concern among MSM and transgender women living with HIV. Holistic, multi-level programmes that address illegal HIV testing and discriminatory hiring practices are urgently needed to facilitate engagement in care and long-term well-being.

Original languageEnglish (US)
Pages (from-to)1-16
Number of pages16
JournalGlobal Public Health
DOIs
StateAccepted/In press - Mar 17 2016

Fingerprint

Dominican Republic
Transgender Persons
HIV
Interviews
Unemployment
Life Change Events
Long-Term Care

Keywords

  • Dominican Republic
  • employment
  • HIV stigma
  • MSM
  • transgender women

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

‘HIV and work don't go together’ : Employment as a social determinant of HIV outcomes among men who have sex with men and transgender women in the Dominican Republic. / Barrington, Clare; Acevedo, Ramon; Donastorg, Yeycy; Perez, Martha; Kerrigan, Deanna.

In: Global Public Health, 17.03.2016, p. 1-16.

Research output: Contribution to journalArticle

@article{e013cad8707144a59205e49069e39738,
title = "‘HIV and work don't go together’: Employment as a social determinant of HIV outcomes among men who have sex with men and transgender women in the Dominican Republic",
abstract = "Men who have sex with men (MSM) and transgender women are disproportionately affected by HIV in the Dominican Republic. Little is known about their experiences living with HIV as a chronic condition. We explored employment as a social determinant of well-being with HIV. We conducted 42 qualitative in-depth interviews with MSM (n = 16) and transgender women (n = 5) living with HIV; each participant completed 2 interviews to facilitate depth and iterative analysis. We used narrative analysis and systematic coding to identify salient themes related to employment and the HIV experience and developed a conceptual model of the pathways between HIV stigma, unemployment, and HIV outcomes. Early life experiences, including rejection from families and school, resulted in limited work opportunities, especially among transgender women. Following HIV diagnosis, participants across all socio-economic levels lost jobs and/or were unable to get jobs due to illegal HIV testing and HIV stigma and discrimination. Not being able to work impacted mental health, engagement in HIV care, and overall well-being. We conclude that lack of employment is a salient concern among MSM and transgender women living with HIV. Holistic, multi-level programmes that address illegal HIV testing and discriminatory hiring practices are urgently needed to facilitate engagement in care and long-term well-being.",
keywords = "Dominican Republic, employment, HIV stigma, MSM, transgender women",
author = "Clare Barrington and Ramon Acevedo and Yeycy Donastorg and Martha Perez and Deanna Kerrigan",
year = "2016",
month = "3",
day = "17",
doi = "10.1080/17441692.2016.1160141",
language = "English (US)",
pages = "1--16",
journal = "Global Public Health",
issn = "1744-1692",
publisher = "Routledge",

}

TY - JOUR

T1 - ‘HIV and work don't go together’

T2 - Employment as a social determinant of HIV outcomes among men who have sex with men and transgender women in the Dominican Republic

AU - Barrington, Clare

AU - Acevedo, Ramon

AU - Donastorg, Yeycy

AU - Perez, Martha

AU - Kerrigan, Deanna

PY - 2016/3/17

Y1 - 2016/3/17

N2 - Men who have sex with men (MSM) and transgender women are disproportionately affected by HIV in the Dominican Republic. Little is known about their experiences living with HIV as a chronic condition. We explored employment as a social determinant of well-being with HIV. We conducted 42 qualitative in-depth interviews with MSM (n = 16) and transgender women (n = 5) living with HIV; each participant completed 2 interviews to facilitate depth and iterative analysis. We used narrative analysis and systematic coding to identify salient themes related to employment and the HIV experience and developed a conceptual model of the pathways between HIV stigma, unemployment, and HIV outcomes. Early life experiences, including rejection from families and school, resulted in limited work opportunities, especially among transgender women. Following HIV diagnosis, participants across all socio-economic levels lost jobs and/or were unable to get jobs due to illegal HIV testing and HIV stigma and discrimination. Not being able to work impacted mental health, engagement in HIV care, and overall well-being. We conclude that lack of employment is a salient concern among MSM and transgender women living with HIV. Holistic, multi-level programmes that address illegal HIV testing and discriminatory hiring practices are urgently needed to facilitate engagement in care and long-term well-being.

AB - Men who have sex with men (MSM) and transgender women are disproportionately affected by HIV in the Dominican Republic. Little is known about their experiences living with HIV as a chronic condition. We explored employment as a social determinant of well-being with HIV. We conducted 42 qualitative in-depth interviews with MSM (n = 16) and transgender women (n = 5) living with HIV; each participant completed 2 interviews to facilitate depth and iterative analysis. We used narrative analysis and systematic coding to identify salient themes related to employment and the HIV experience and developed a conceptual model of the pathways between HIV stigma, unemployment, and HIV outcomes. Early life experiences, including rejection from families and school, resulted in limited work opportunities, especially among transgender women. Following HIV diagnosis, participants across all socio-economic levels lost jobs and/or were unable to get jobs due to illegal HIV testing and HIV stigma and discrimination. Not being able to work impacted mental health, engagement in HIV care, and overall well-being. We conclude that lack of employment is a salient concern among MSM and transgender women living with HIV. Holistic, multi-level programmes that address illegal HIV testing and discriminatory hiring practices are urgently needed to facilitate engagement in care and long-term well-being.

KW - Dominican Republic

KW - employment

KW - HIV stigma

KW - MSM

KW - transgender women

UR - http://www.scopus.com/inward/record.url?scp=84961392809&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84961392809&partnerID=8YFLogxK

U2 - 10.1080/17441692.2016.1160141

DO - 10.1080/17441692.2016.1160141

M3 - Article

C2 - 26999251

AN - SCOPUS:84961392809

SP - 1

EP - 16

JO - Global Public Health

JF - Global Public Health

SN - 1744-1692

ER -