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3. Exploring antiretroviral therapy adherence, competing needs, and viral suppression among people living with HIV and food insecurity in the Dominican Republic

Author

Derose, Kathryn P, Han, Bing, Armenta, Gabriela, Palar, Kartika, Then-Paulino, Amarilis, Jimenez-Paulino, Gipsy, Sheira, Lila A, Acevedo, Ramón, Lugo, Claudio, Veloz, Isidro, Donastorg, Yeycy, and Wagner, Glenn

Subjects
Public Health, Health Sciences, Behavioral and Social Science, Social Determinants of Health, Pediatric, Sexually Transmitted Infections, HIV/AIDS, Prevention, Clinical Research, Infectious Diseases, Clinical Trials and Supportive Activities, Mental Health, Health Disparities, Pediatric AIDS, Management of diseases and conditions, 7.1 Individual care needs, Infection, Zero Hunger, Anti-Retroviral Agents, Dominican Republic, Food Insecurity, Food Supply, HIV Infections, Haiti, Humans, Medication Adherence, Pilot Projects, Viral Load, HIV, food insecurity, viral suppression, competing needs, Public Health and Health Services, Psychology, Public health, Sociology, Clinical and health psychology
Abstract

Understanding factors related to suboptimal adherence to antiretroviral therapy (ART) and detectable viral load (VL), especially among vulnerable populations, is needed to improve HIV outcomes. The Caribbean is highly impacted by HIV and socioeconomic inequalities, but few studies have been conducted there to explore food insecurity among people with HIV and factors associated with viral suppression in this vulnerable population. Using baseline data from a pilot intervention trial among people living with HIV and food insecurity in the Dominican Republic, we examined psychosocial and behavioral factors associated with viral suppression, ART adherence, and competing needs. Among participants (n = 115), 61% had a detectable VL; the strongest factor associated with detectable VL was having missed taking ART in the last six months due to not having food (OR = 2.68, p = 0.02). Greater odds of reporting missed ART doses due to not having food were associated with severe food insecurity (OR = 4.60, p = 0.006), clinical depression (OR = 2.76, p = 0.018), Haitian background (OR = 6.62 p = 0.017), and internalized HIV stigma (OR = 1.09, p = 0.041), while lower odds were associated with social support (OR = 0.89, p = 0.03) and having health insurance (OR = 0.27, p = 0.017). Ensuring that people with HIV and food insecurity have food to take with their ART is essential for viral suppression.

Published
2022

6. Preliminary Effects of an Urban Gardens and Peer Nutritional Counseling Intervention on HIV Treatment Adherence and Detectable Viral Load Among People with HIV and Food Insecurity: Evidence from a Pilot Cluster Randomized Controlled Trial in the Dominican Republic

Author

Derose, Kathryn P., Then-Paulino, Amarilis, Han, Bing, Armenta, Gabriela, Palar, Kartika, Jimenez-Paulino, Gipsy, Sheira, Lila A., Acevedo, Ramón, Fulcar, María A., Lugo Bernard, Claudio, Veloz Camacho, Isidro, Donastorg, Yeycy, and Wagner, Glenn J.

Published
2023
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9. Efficacy and safety of the CVnCoV SARS-CoV-2 mRNA vaccine candidate in ten countries in Europe and Latin America (HERALD): a randomised, observer-blinded, placebo-controlled, phase 2b/3 trial

Author

Lovesio, Luciano, Diez, Fabián, Grazziani, Franco, Ganaha, Maria Cristina, Zalatnik, Viviana Judith, Dittrich, Ricardo Julio, Espínola, Lidia, Lambert, Sandra, Longhi, Andrea, Vecchio, Claudia, Mastruzzo, María, Fernandez, Alberto, Borchowiek, Silvina, Potito, Roberto, Ahuad Guerrero, Rodolfo Andres, Guardiani, Fernando Martin, Castella, Sofia, Foccoli, Monica, Pedernera, Aldana, Braida, Ariel, Durigan, Virginia, Martella, Carolina, Bobat, Antonela, Boggia, Bruno Emilio, Nemi, Sergio Andrés, Tartaglione, Javier Gerardo, Piedimonte, Fabián César, De Bie, Jessie, Reynales Londoño, Humberto, Rodríguez Ordoñez, Paula Andrea, García Cruz, Johanna Marcela, Bautista Toloza, Leonardo, Ladino González, Margot Cecilia, Zambrano Ochoa, Adriana Pilar, Prieto Pradera, Iñigo, Torres Hernandez, Daniela, Mazo Elorza, Diana Patricia, Collazos Lennis, Maria Fernanda, Vanegas Dominguez, Beatriz, Solano Mosquera, Lina Marianur, Fendel, Rolf, Fleischmann, Wim Alexander, Koehne, Erik, Kreidenweiss, Andrea, Köhler, Carsten, Esen, Meral, Horn, Carola, Eberts, Sandra, Kroidl, Arne, Huber, Kristina, Thiel, Verena, Mazara Rosario, Sonia, Reyes, Gilda, Rivera, Laura, Donastorg, Yeycy, Lantigua, Flavia, Torres Almanzar, Dania, Candelario, Rosalba, Peña Mendez, Lourdes, Rosario Gomez, Nadia, Portolés-Pérez, Antonio, Ascaso del Río, Ana, Laredo Velasco, Leonor, Bustinduy Odriozola, Maria Jesus, Larrea Arranz, Igor, Martínez Alcorta, Luis Ignacio, Durán Laviña, María Isabel, Imaz-Ayo, Natale, Meijide, Susana, García-de-Vicuña, Aitor, Santorcuato, Ana, Gallego, Mikel, Aguirre-García, Gloria Mayela, Olmos Vega, Jocelyn, González Limón, Pablo, Vázquez Villar, Andrea, Chávez Barón, Jaime, Arredondo Saldaña, Felipe, Luján Palacios, Juan de Dios, Camacho Choza, Laura Julia, Vázquez Saldaña, Eduardo Gabriel, Ortega Dominguez, Sandra Janeth, Vega Orozco, Karen Sofia, Torres Quiroz, Ivonne Aimee, Martinez Avendaño, Alejandro, Herrera Sanchez, Javier, Guzman, Esperanza, Castro Castrezana, Laura, Ruiz Palacios y Santos, Guillermo Miguel, de Winter, Ronald Frank Jacobus, de Jonge, Hanna K, Schnyder, Jenny L, Boersma, Wim, Hessels, Lisa, Djamin, Remco, van der Sar, Simone, DeAntonio, Rodrigo, Peña, Moisés, Rebollon, Gabriel, Rojas, Marianela, Escobar, Johnny, Hammerschlag Icaza, Bruno, Wong T, Digna Y, Barrera Perigault, Paulo, Ruiz, Sergio, Chan, Milagros, Arias Hoo, Dommie Janneth, Gil, Ana I, Celis, Carlos R, Balmaceda, Maria Pia, Flores, Omar, Ochoa, Mayra, Peña, Bia, de la Flor, Carolina, Webb, Camille María, Cornejo, Enrique, Sanes, Fatima, Mayorga, Valerie, Valdiviezo, Gladys, Ramírez Lamas, Suzanne Pamela, Grandez Castillo, Gustavo Alberto, Lama, Javier R, Matta Aguirre, Milagros Erika, Arancibia Luna, Lesly Angela, Carbajal Paulet, Óscar, Zambrano Ortiz, José, Camara, Anais, Guzman Quintanilla, Fernanda, Diaz-Parra, Carmen, Morales-Oliva, Jose, Cornejo, Rubelio E, Ricalde, Sheby A, Vidal, Jhonny, Rios Nogales, Luis, Cheatham-Seitz, Darline, Gregoraci, Giorgia, Brecx, Alain, Walz, Lisa, Vahrenhorst, Dominik, Seibel, Tobias, Quintini, Gianluca, Kremsner, Peter G, Ahuad Guerrero, Rodolfo Andrés, Arana-Arri, Eunate, Aroca Martinez, Gustavo Jose, Bonten, Marc, Chandler, Reynaldo, Corral, Gonzalo, De Block, Eddie Jan Louis, Ecker, Lucie, Gabor, Julian Justin, Garcia Lopez, Carlos Alberto, Gonzales, Lucy, Granados González, María Angélica, Gorini, Nestor, Grobusch, Martin P, Hrabar, Adrian D, Junker, Helga, Kimura, Alan, Lanata, Claudio F, Lehmann, Clara, Leroux-Roels, Isabel, Mann, Philipp, Martinez-Reséndez, Michel Fernando, Ochoa, Theresa J, Poy, Carlos Alberto, Reyes Fentanes, Maria Jose, Rivera Mejia, Luis Maria, Ruiz Herrera, Vida Veronica, Sáez-Llorens, Xavier, Schönborn-Kellenberger, Oliver, Schunk, Mirjam, Sierra Garcia, Alexandra, Vergara, Itziar, Verstraeten, Thomas, Vico, Marisa, and Oostvogels, Lidia

Published
2022
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10. Family rejection, acceptance, support and health among transgender women sex workers living with HIV in Santo Domingo, Dominican Republic.

Author

Higgins, Isabella C. A., Goldenberg, Tamar, Gomez, Hoisex, Perez, Martha, Donastorg, Yeycy, Kerrigan, Deanna, and Barrington, Clare

Subjects
SEX work, HEALTH status indicators, QUALITATIVE research, RESEARCH funding, HIV-positive persons, INTERVIEWING, QUESTIONNAIRES, FAMILY relations, JUDGMENT sampling, FAMILY attitudes, TRANS women, FAMILY support, SOCIAL support, HOUSING, PSYCHOLOGICAL tests
Abstract

Background: Rejection from parents can lead transgender (trans) youth and young adults to experience poor health outcomes, while parental and sibling acceptance and support can be protective against poor health outcomes. The role of family in adult trans women's lives has been minimally investigated. Aim: This study aimed to explore experiences of familial rejection, acceptance, and support in the lives of trans women sex workers living with HIV in the Dominican Republic. Method: In-depth interviews were conducted with 21 trans women ages 23 to 49 in Santo Domingo in 2019. We conducted a qualitative analysis of the interviews. We developed narrative summaries and a case-based matrix to analyze data within and across participants and confirm patterns and themes in the data. Results: Familial rejection and acceptance were processes with most participants receiving acceptance from at least one family member over time as well as receiving emotional and instrumental support. Poor health outcomes influenced by rejection and lack of support included suicide attempts, depression, and substance use. Conversely, acceptance and support bolstered well-being and provided housing stability and assistance with HIV treatment. Conclusion: Family rejection and acceptance play an important role throughout the life course. Working with families to become accepting of their trans family members could improve trans women's health outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Comparing Stigma and HIV Outcomes Between Transgender and Cisgender Women Sex Workers Living with HIV in the Dominican Republic.

Author

Goldenberg, Tamar, Karver, Tahilin, Kerrigan, Deanna, Gomez, Hoisex, Perez, Martha, Donastorg, Yeycy, and Barrington, Clare

Subjects
SEX work, CROSS-sectional method, SELF-evaluation, SCALE analysis (Psychology), T-test (Statistics), RESEARCH funding, MEDICAL care, SOCIOECONOMIC factors, QUESTIONNAIRES, FISHER exact test, HIV infections, TREATMENT effectiveness, DESCRIPTIVE statistics, CHI-squared test, LONGITUDINAL method, INTERSECTIONALITY, CISGENDER people, CONCEPTUAL structures, TRANS women, SOCIODEMOGRAPHIC factors, COMPARATIVE studies, DISCRIMINATION (Sociology), DATA analysis software, SOCIAL stigma
Abstract

Purpose: Using an intersectionality framework, we compared stigma and HIV care and treatment outcomes across transgender and cisgender women sex workers living with HIV in the Dominican Republic (DR). Methods: In 2018–2019, data were collected in Santo Domingo, DR, using interviewer-administered surveys among 211 cisgender women and 100 transgender women. We used t-tests and chi-square tests to examine differences in sex work stigma, HIV stigma, and HIV care and treatment. Results: Transgender participants reported more anticipated HIV stigma (mean=13.61, standard deviation [SD]=2.39) than cisgender participants (mean=12.96, SD=2.21; p=0.018), but there were no statistically significant differences for internalized or enacted HIV stigma. Cisgender participants reported more anticipated sex work stigma (cisgender: mean=50.00, SD=9.22; transgender: mean=44.02, SD=9.54; p<0.001), but transgender women reported more enacted (cisgender: mean=49.99, SD=9.11; transgender: mean=59.93, SD=4.89; p<0.001) and internalized sex work stigma (cisgender: mean=50.00, SD=8.80; transgender: mean=57.84, SD=8.34; p<0.001), with no significant differences in resistance to sex work stigma. Cisgender women were significantly more likely to have received HIV care (cisgender: 99.53%, transgender: 91.00%, p<0.001), be currently taking antiretroviral therapy (cisgender: 96.21%, transgender: 84.00%, p<0.001), and be virally suppressed (cisgender: 76.19%, transgender: 64.00%, p=0.025). Conclusions: Transgender participants consistently had poorer HIV care and treatment outcomes compared with cisgender participants. Differences in stigma experiences between transgender and cisgender participants depended on the type of stigma. Findings reflect the intersectional nature of distinct types and forms of stigma among sex workers. Understanding the shared and unique experiences of transgender and cisgender women will improve HIV care engagement and viral suppression. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Generalizable deep neural networks for image quality classification of cervical images

Author

Ahmed, Syed Rakin, primary, Befano, Brian, additional, Egemen, Didem, additional, Rodriguez, Ana Cecilia, additional, Desai, Kanan, additional, Jeronimo, Jose, additional, Ajenifuja, Kayode, additional, Clark, Christopher, additional, Perkins, Rebecca, additional, Campos, Nicole, additional, Inturrisi, Federica, additional, Wentzensen, Nicolas, additional, Han, Paul, additional, Guillen, Diego, additional, Norman, Judy, additional, Goldstein, Andrew, additional, Madeleine, Margaret, additional, Donastorg, Yeycy, additional, Schiffman, Mark, additional, de Sanjose, Silvia, additional, and Kalpathy-Cramer, Jayashree, additional

Published
2024
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23. Abriendo Puertas: A Multi-level Intervention to Improve HIV Outcomes by Addressing Stigma and Discrimination Among Female Sex Workers in the Dominican Republic

Author

Kerrigan, Deanna, Barrington, Clare, Carrasco, Maria, Mantsios, Andrea, Perez, Martha, Gomez, Hoisex, Donastorg, Yeycy, Aggleton, Peter, Series editor, Kalichman, Seth, Series editor, Kippax, Susan, Series editor, Parker, Richard G., Series editor, de Wit, John, Series editor, Kerrigan, Deanna, editor, and Barrington, Clare, editor

Published
2018
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24. 1843. Exploring Cisgender Women's HIV Pre-Exposure Prophylaxis (PrEP) Needs and Preferences Across Settings: the Roles of Social-Structural Factors

Author

Kerrigan, Deanna, primary, Yonamine, Kimi, additional, O’Rourke, Allison, additional, Karver, Tahilin Sanchez, additional, Davis, Wendy W, additional, Metzner, Aimee A, additional, Oglesby, Alan, additional, Garris, Cindy, additional, Scott, Rachel, additional, Moriarty, Patricia, additional, Taggart, Tamara, additional, Barrington, Clare, additional, Gomez, Hoisex, additional, Perez, Martha, additional, and Donastorg, Yeycy, additional

Published
2023
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25. Individual and Collective Forms of Stigma Resistance: Pathways Between HIV and Sex Work Stigma and Viral Suppression Among Female Sex Workers in the Dominican Republic

Author

Kerrigan, Deanna, primary, Barrington, Clare, additional, Donastorg, Yeycy, additional, Perez, Martha, additional, Gomez, Hoisex, additional, Davis, Wendy, additional, Beckham, S. Wilson, additional, Karver, Tahilin Sanchez, additional, Mantsios, Andrea, additional, and Galai, Noya, additional

Published
2023
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31. Trajectories of HIV management among virally suppressed and unsuppressed female sex workers in the Dominican Republic: A comparative qualitative analysis.

Author

Savage, Virginia, Gomez, Hoisex, Perez, Martha, Donastorg, Yeycy, Kerrigan, Deanna, and Barrington, Clare

Subjects
DIAGNOSIS of HIV infections, WELL-being, HIV-positive persons, VIRAL load, RESEARCH methodology, SEX work, WOMEN, INTERVIEWING, QUALITATIVE research, COMPARATIVE studies, EXPERIENCE, HEALTH behavior, DRUGS, RESEARCH funding, JUDGMENT sampling, PATIENT compliance, DATA analysis software, THEMATIC analysis
Abstract

Purpose: Despite suboptimal HIV outcomes among female sex workers (FSW), limited research has been conducted on factors that impact viral suppression among this population. Examining narratives of HIV management, we examined how experiences of diagnosis, treatment initiation, and ongoing care behaviours shaped viral suppression outcomes over time. Methods: We conducted 20 in-depth interviews with FSW in Santo Domingo, Dominican Republic. Using narrative and thematic qualitative approaches, we developed analytic summaries and matrices to compare trajectories of managing HIV between suppressed and unsuppressed participants. Results: Regardless of suppression status, participants described similar narratives of overcoming initial challenges to HIV management through personal resilience and social support. Unsuppressed participants identified more delays in initiating antiretroviral therapy and more lapses in adherence due to less active acceptance of their HIV status and more persistent experiences of economic hardship and HIV stigma. Conclusions: We found that individual, interpersonal and structural factors, including stigma and economic precarity, differentiated trajectories towards viral suppression among FSW indicating the importance of multilevel interventions. Improved access to mental health services and social support could promote greater early acceptance of HIV status and progress towards viral suppression among FSW. [ABSTRACT FROM AUTHOR]

Published
2023
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36. Relationships Between Stigma and Intimate Partner Violence Among Female Sex Workers Living With HIV: Social and Economic Exclusion.

Author

Rock, Amelia, McNaughton Reyes, H. Luz, Go, Vivian, Maman, Suzanne, Perez, Martha, Donastorg, Yeycy, Kerrigan, Deanna, and Barrington, Clare

Subjects
WELL-being, CONFIDENCE intervals, SOCIAL support, PSYCHOLOGICAL vulnerability, INDEPENDENT variables, MULTIVARIATE analysis, SOCIAL stigma, SEX work, MENTAL health, INTIMATE partner violence, SOCIOECONOMIC factors, SOCIAL isolation, SURVEYS, MATHEMATICAL variables, SELF-efficacy, RESEARCH funding, HYPOTHESIS, DESCRIPTIVE statistics, ODDS ratio, PSYCHOLOGY of HIV-positive persons
Abstract

Violence against female sex workers (FSWs) perpetrated by their intimate (i.e., non-commercial) partners, particularly against FSWs living with HIV, is understudied. Stigma can deplete the economic resources, social relationships, and mental well-being of stigmatized people, which may increase their intimate partner violence (IPV) risk. We quantitatively assessed relationships between HIV stigma and sex work stigma and IPV victimization among FSWs living with HIV in the Dominican Republic (n = 266). Enacted HIV stigma, in the form of job loss, and anticipated HIV stigma, in the form of fear of exclusion by family, were associated with increased IPV risk. Potential association mechanisms, including increased economic vulnerability and social isolation, and programmatic responses are discussed. [ABSTRACT FROM AUTHOR]

Published
2023
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37. High burden of sexually transmitted infections among under-resourced populations in the Dominican Republic

Author

Amesty, Silvia, primary, Perez-Figueroa, Rafael, additional, Stonbraker, Samantha, additional, Halpern, Mina, additional, Donastorg, Yeycy, additional, Perez-Mencia, Martha, additional, Lantigua, Flavia, additional, Soriano, Leidy, additional, Baez-Caraballo, Pamela, additional, Gilbert, Jeffrey, additional, Buccini, Frank, additional, Sharp, James, additional, Hernandez, Brian, additional, Gelfond, Jonathan, additional, Cardwell, Ethan, additional, Nicholas, Catherine, additional, Egan, Kelsey A., additional, Gomes, Angelina, additional, Van Dyke, Elizabeth, additional, Nicholas, Stephen W., additional, Grodman, Marc, additional, and Taylor, Barbara S., additional

Published
2023
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40. “She is the one who knows”: A qualitative exploration of oral and injectable PrEP as part of a community empowerment approach to HIV prevention among female sex workers in the Dominican Republic and Tanzania

Author

Mantsios, Andrea, primary, Muraleetharan, Ohvia, additional, Donastorg, Yeycy, additional, Perez, Martha, additional, Gomez, Hoisex, additional, Shembilu, Catherine, additional, Beckham, S. Wilson, additional, Karver, Tahilin Sanchez, additional, Davis, Wendy, additional, Likindikoki, Samuel, additional, Mbwambo, Jessie, additional, Barrington, Clare, additional, and Kerrigan, Deanna, additional

Published
2022
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41. Preliminary Effects of an Urban Gardens and Peer Nutritional Counseling Intervention on HIV Treatment Adherence and Detectable Viral Load Among People with HIV and Food Insecurity: Evidence from a Pilot Cluster Randomized Controlled Trial in the Dominican Republic

Author

Derose, Kathryn P., primary, Then-Paulino, Amarilis, additional, Han, Bing, additional, Armenta, Gabriela, additional, Palar, Kartika, additional, Jimenez-Paulino, Gipsy, additional, Sheira, Lila A., additional, Acevedo, Ramón, additional, Fulcar, María A., additional, Lugo Bernard, Claudio, additional, Veloz Camacho, Isidro, additional, Donastorg, Yeycy, additional, and Wagner, Glenn J., additional

Published
2022
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48. Exploring antiretroviral therapy adherence, competing needs, and viral suppression among people living with HIV and food insecurity in the Dominican Republic.

Author

Derose, Kathryn, Derose, Kathryn, Han, Bing, Armenta, Gabriela, Palar, Kartika, Then-Paulino, Amarilis, Jimenez-Paulino, Gipsy, Acevedo, Ramón, Lugo, Claudio, Veloz, Isidro, Donastorg, Yeycy, Wagner, Glenn, Sheira, Lila, Derose, Kathryn, Derose, Kathryn, Han, Bing, Armenta, Gabriela, Palar, Kartika, Then-Paulino, Amarilis, Jimenez-Paulino, Gipsy, Acevedo, Ramón, Lugo, Claudio, Veloz, Isidro, Donastorg, Yeycy, Wagner, Glenn, and Sheira, Lila

Abstract

Understanding factors related to suboptimal adherence to antiretroviral therapy (ART) and detectable viral load (VL), especially among vulnerable populations, is needed to improve HIV outcomes. The Caribbean is highly impacted by HIV and socioeconomic inequalities, but few studies have been conducted there to explore food insecurity among people with HIV and factors associated with viral suppression in this vulnerable population. Using baseline data from a pilot intervention trial among people living with HIV and food insecurity in the Dominican Republic, we examined psychosocial and behavioral factors associated with viral suppression, ART adherence, and competing needs. Among participants (n = 115), 61% had a detectable VL; the strongest factor associated with detectable VL was having missed taking ART in the last six months due to not having food (OR = 2.68, p = 0.02). Greater odds of reporting missed ART doses due to not having food were associated with severe food insecurity (OR = 4.60, p = 0.006), clinical depression (OR = 2.76, p = 0.018), Haitian background (OR = 6.62 p = 0.017), and internalized HIV stigma (OR = 1.09, p = 0.041), while lower odds were associated with social support (OR = 0.89, p = 0.03) and having health insurance (OR = 0.27, p = 0.017). Ensuring that people with HIV and food insecurity have food to take with their ART is essential for viral suppression.

Published
2022

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