Violence from a sexual partner is significantly associated with poor HIV care and treatment outcomes among female sex workers in the Dominican Republic

Carlisdania Mendoza, Clare Barrington, Yeycy Donastorg, Martha Perez, Paul J. Fleming, Michele R. Decker, Deanna Kerrigan

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Female sex workers (FSWs) experience high rates of violence from their sexual partners. Although violence is associated with HIV risk behaviors among FSWs, there is limited evidence on the association between violence and HIV treatment outcomes. Methods: We analyzed data from a socio-behavioral survey with a cohort of FSWs living with HIV in the Dominican Republic (n = 268) to describe the burden of violence from a sexual partner in the last 6 months. We assessed the relationship between violence and HIV treatment outcomes, comparing findings across 2 types of sexual partners: intimate partners and clients. Results: Nearly one-fifth of women (18.3%) experienced violence in the last 6 months. More women experienced violence from an intimate partner (12.3%) than a client (8.3%), with some (2.6%) reporting both. Although violence from an intimate partner was significantly associated with not currently being on antiretroviral treatment [ART; adjusted odds ratio (AOR): 4.05, 95% confidence interval (CI): 1.00 to 16.36] and missing an ART dose in the last 4 days (AOR: 5.26, 95% CI: 1.91 to 14.53), violence from a client was associated with never having received HIV care (AOR: 2.85, 95% CI: 1.03 to 7.92) and ever interrupting ART (AOR: 5.45, 95% CI: 1.50 to 19.75). Conclusions: Violence from a sexual partner is associated with poor HIV treatment outcomes among FSWs. Different patterns by type of partner reflect how relationship dynamics may influence these associations. Violence prevention and support services should be tailored based on type of partner. Violence screening and referrals should be integrated into HIV care services for FSWs to improve their health and reduce ongoing transmission.

Original languageEnglish (US)
Pages (from-to)273-278
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume74
Issue number3
DOIs
StatePublished - Mar 1 2017

Keywords

  • ART
  • Adherence
  • Dominican Republic
  • Female sex workers
  • HIV
  • Violence

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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