Mindfulness, Mental Health and HIV Outcomes Among Female Sex Workers in the Dominican Republic and Tanzania

Deanna Kerrigan; Tahilin Sanchez Karver; Clare Barrington; Yeycy Donastorg; Martha Perez; Hoisex Gomez; Jessie Mbwambo; Samuel Likindikoki; Wendy Davis; S Wilson Beckham; Andrea Mantsios; Noya Galai; Erica Sibinga

doi:10.1007/s10461-021-03168-1

Mindfulness, Mental Health and HIV Outcomes Among Female Sex Workers in the Dominican Republic and Tanzania

AIDS Behav. 2021 Sep;25(9):2941-2950. doi: 10.1007/s10461-021-03168-1. Epub 2021 Jan 28.

Authors

Affiliations

¹ Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, D.C., USA.
² Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
³ Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
⁴ HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic.
⁵ Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
⁶ Public Health Innovation and Action, New York, NY, USA. armantsios@gmail.com.
⁷ Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
⁸ Department of Statistics, University of Haifa, Mt Carmel, Israel.
⁹ Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.

Abstract
in English, Spanish

We examined the relationship between mindfulness, mental health and HIV outcomes among female sex workers (FSW) from the Dominican Republic (DR) (n = 201) and Tanzania (n = 208) using cross-sectional survey and biologic data. We employed stratified multivariate linear and logistic regression. Depression was associated with lower odds of ART adherence in the DR (AOR 0.25, 95% CI: 0.08-0.78) and of viral suppression in Tanzania (AOR 0.49, 95% CI: 0.24-0.97). In both countries, mindfulness was associated with lower odds of moderate to severe depression (AOR 0.82, 95% CI: 0.76-0.88 for the DR; AOR 0.85, 95% CI: 0.77-0.95 for Tanzania). In the DR, mindfulness was associated with lower odds of anxiety (AOR 0.83, 95% CI: 0.77-0.89), lower HIV stigma (β = - 0.28 per unit change, 95% CI: - 0.37 to - 0.19) and greater odds of viral suppression (AOR 1.09, 95% CI: 1.02-1.15). Findings demonstrate the potential of tailored mindfulness interventions to improve mental health and HIV outcomes among FSW.

Examinamos la relación entre la atención plena, la salud mental y los resultados del VIH entre las trabajadoras sexuales (TRSX) de la República Dominicana (RD) (n = 201) y Tanzania (n = 208) utilizando una encuesta transversal y datos biológicos. Empleamos regresión lineal multivariada estratificada y regresión logística. La depresión se asoció con menores probabilidades de adherencia al terapia antiretroviral (TAR) en la República Dominicana (AOR 0.25, IC del 95%: 0.08–0.78) y de supresión viral en Tanzania (AOR 0.49, IC del 95%: 0.24–0.97). En ambos países, la atención plena se asoció con menores probabilidades de depresión moderada a grave (AOR 0.82, IC del 95%: 0.76–0.88 para la República Dominicana; AOR 0.85, IC del 95%: 0.77–0.95 para Tanzania). En la República Dominicana, la atención plena se asoció con menores probabilidades de ansiedad (AOR 0.83, IC del 95%: 0.77–0.89), menor estigma del VIH (β = − 0.28 por unidad de cambio, IC del 95%: − 0.37 to − 0.19) y mayores probabilidades de supresión viral (AOR 1.09, 95% CI: 1.02–1.15). Los hallazgos demuestran el potencial de las intervenciones de atención plena para mejorar la salud mental y los resultados del VIH entre las TRSX.

Keywords: Depression/anxiety; HIV; Mindfulness; Sex work; Stigma.

MeSH terms

Cross-Sectional Studies
Dominican Republic / epidemiology
Female
HIV Infections* / epidemiology
HIV Infections* / prevention & control
Humans
Mental Health
Mindfulness*
Sex Workers*
Tanzania / epidemiology

Abstract in English, Spanish

MeSH terms

Grants and funding

Abstract
in English, Spanish