Substance Use and Depression Impede ART Adherence Among Female Sex Workers Living with HIV in the Dominican Republic

  • Yan Wang
  • , Tahilin Sanchez Karver
  • , Carla J. Berg
  • , Clare Barrington
  • , Yeycy Donastorg
  • , Martha Perez
  • , Hoisex Gomez
  • , Wendy Davis
  • , Noya Galai
  • , Deanna Kerrigan

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Female sex workers (FSW) have worse HIV outcomes in part due to lower anti-retroviral therapy (ART) adherence. Substance use and depression are important barriers to ART adherence, yet few studies have assessed these relationships among FSW in longitudinal studies. Cross-Lagged Panel Models and autoregressive mediation analyses assessed substance use (illicit drug use and alcohol use disorders) in relation to ART non-adherence and the mediation role of depressive symptoms among 240 FSW living with HIV in the Dominican Republic. In annual visits (T1, T2, T3), the majority (70%, 66%, and 53%) reported at-risk drinking and 15%, 13% and 9% used illicit drug during the past 6 months. Most FSW (70%, 62% and 46%) had mild-to-severe depression. Illicit drug use predicted later ART non-adherence. This relationship was not mediated via depressive symptoms. Integrated substance use and HIV care interventions are needed to promote ART adherence and viral suppression among FSW.

Original languageEnglish
Pages (from-to)2079-2088
Number of pages10
JournalAIDS and Behavior
Volume27
Issue number7
DOIs
StatePublished - 1 Jul 2023
Externally publishedYes

Keywords

  • ART adherence
  • Depression
  • HIV
  • Sex work
  • Substance use

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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