HIV Stigma Mediates the Association Between Social Cohesion and Consistent Condom Use Among Female Sex Workers Living with HIV in the Dominican Republic

Maria Augusta Carrasco, Trang Q. Nguyen, Clare Barrington, Martha Perez, Yeycy Donastorg, Deanna Kerrigan

Research output: Contribution to journalArticle

Abstract

Evidence indicates that social cohesion is a successful strategy to improve consistent condom use (CCU) among female sex workers. However, the individual and layered or combined effect that various types of overlapping stigmas may have on CCU between female sex workers living with HIV and their clients and steady partners has not been analyzed. Drawing on the Abriendo Puertas cohort of female sex workers living with HIV in the Dominican Republic, we used structural equation modeling to test the hypothesis that both HIV stigma and sex work stigma mediate the association between social cohesion and CCU and that they have a layered effect. The results indicated that HIV stigma mediated the association between social cohesion and CCU with clients and partners, while sex work-related stigma did not. There was no evidence of a layered HIV stigma and sex work stigma effect, which may be due to methodological limitations to handle highly correlated latent variables. Findings highlight the need to address internalized HIV stigma within the context of community-based approaches to enhance their HIV prevention impact. This will help to reduce the risk of HIV re-infection with a new distinct HIV viral strain, STI infection, and onward HIV transmission among female sex workers living with HIV.

Original languageEnglish (US)
Pages (from-to)1529-1539
Number of pages11
JournalArchives of Sexual Behavior
Volume47
Issue number5
DOIs
StatePublished - Jul 1 2018

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Keywords

  • Dominican Republic
  • Female sex workers
  • HIV prevention
  • People living with HIV
  • Social cohesion

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Psychology(all)

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