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In this study, we explore how individuals living with HIV in the Dominican Republic strive to live a ‘normal’ life and the consequences of this pursuit of normalcy. We conducted qualitative in-depth interviews with men (n= 20) and women (n= 20) living with HIV and receiving care at two urban clinics in Santo Domingo. We analysed the data using a combination of narrative analysis and thematic coding. We aimed to identify how fears and/or lived experiences with social rejection and HIV-related stigma and discrimination shaped participants’ abilities to maintain social relationships, be economically productive and manage HIV within the context of sexual relationships. Participants used the discourse ofuna vida normal(a normal life) to frame their response to HIV. This pursuit of normality was driven by the social and economic pressures of living with a chronic condition in a context of HIV-related stigma; trying to keep things ‘normal’ further added to these pressures. We argue that the normal life discourse fails to recognise the dynamic and complex nature of negotiating this condition and may also create additional burdens for individuals living with HIV that could impact their wellbeing and preventive behaviours. [ABSTRACT FROM PUBLISHER]

This study explored local perceptions regarding the potential influence of an HIV vaccine on sexual-risk behaviours in Santo Domingo, Dominican Republic. Qualitative in-depth interviews were carried out with 25 participants, including 15 women and 10 men. Approximately half of the male study participants stated that they would increase their number of sexual partners and/or would not use condoms if they received an HIV vaccine. In contrast, women reported that they would be unlikely to change their own behaviour, but stated that an HIV vaccine would allow them to worry less about the sexual-risk behaviour of their male partners. Our findings suggest the need to utilize existing HIV-prevention programmes to support future HIV vaccine research and distribution efforts and minimize increased risk behaviour. Such efforts should actively assess and address the role of culturally-defined gender norms on behavioural responses to the introduction of HIV vaccines. [ABSTRACT FROM AUTHOR]

Background: Health providers can play an important role in communication about pregnancy, particularly for women at increased risk for pregnancy complications, including female sex workers (FSWs) living with HIV. This study explored factors related to patient-provider communication about pregnancy among 253 FSWs living with HIV of reproductive age in Santo Domingo, Dominican Republic.Methods: A cross-sectional design was employed including structured socio-behavioral surveys. Data were analyzed utilizing bivariate and multivariate logistic regression.Results: Of the 253 FSWs living with HIV in this study, 95.7% had been pregnant at least once (median: 4; IQR: 3,6), 28.0% wanted more children and 36% reported a pregnancy after HIV diagnosis. Over half of participants (58.0%) reported having ever spoken to a health provider about pregnancy while living with HIV. Multivariate logistic regression found significant associations between having spoken to a health provider about HIV in pregnancy and a more positive perception of their provider (AOR: 2.0; 95% CI: 1.0, 2.5) and years since HIV diagnosis (AOR: 1.1; 95% CI: 1.0, 1.1). Participants were less likely to speak with a provider if they had a history of drug use (AOR: 0.4; 95% CI: 0.2, 0.9) or current alcohol use (AOR: 0.5; 95% CI: 0.3, 0.9).Conclusion: Findings highlight the importance of non-judgmental and tailored provider-initiated conversations surrounding pregnancy. Future research is needed to better understand how and when pregnancy communication is initiated, as well as the content of clinical care conversations, to address the reproductive health of FSWs living with HIV. [ABSTRACT FROM AUTHOR]