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Cited by 25Sex work and related issuesHIV/AIDS Research and InterventionsMindfulness and Compassion Interventions

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

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Kerrigan, Deanna, Karver, Tahilin Sanchez, Barrington, Clare, Donastorg, Yeycy, Perez, Martha, Gomez, Hoisex, Mbwambo, Jessie, Likindikoki, Samuel +5 more·2021·AIDS and Behavior
DOI 10.1007/s10461-021-03168-1PMC PMC8316480
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Abstract

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.

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  • Poor mental health can decrease the intention and capacity of PLWH to engage with HIV-related care, including attending appointments and taking their medication.

    “Poor mental health can decrease the intention and capacity of PLWH to engage with HIV-related care, including attending appointments and taking their medication.23,41–43”

    From Mindfulness, Mental Health, and Violence Exposure Among Transgender Female Sex Workers Living with HIV in the Dominican Republic. (2026) · cites this paper as [23]

    The Results (Factors associated with HIV care continuum outcomes; page unavailable) report that depression was associated with lower self-reported ART adherence among female sex workers living with HIV in the Dominican Republic. The Introduction also describes depression as a predictor of lower ART adherence among people living with HIV generally. The paper does not establish that poor mental health decreases intention or capacity to engage in care, or address attendance at appointments; its reported findings are associations, not causal effects. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Among cisgender FSW living with HIV in the Dominican Republic, mindfulness significantly reduced the odds of having moderate-to-severe depression and anxiety.

    “Among cisgender FSW living with HIV in the DR, for example, mindfulness significantly reduced the odds of having moderate-to-severe depression and anxiety. 23”

    From Mindfulness, Mental Health, and Violence Exposure Among Transgender Female Sex Workers Living with HIV in the Dominican Republic. (2026) · cites this paper as [23]

    The Results (Factors associated with mental health outcomes; page unavailable) report significantly lower odds of moderate-to-severe depression and of anxiety with greater mindfulness among female sex workers living with HIV in the Dominican Republic. The Methods (Measures; page unavailable) define the anxiety outcome as borderline abnormal or abnormal, not moderate-to-severe. Because the study used cross-sectional data, its reported associations also do not establish that mindfulness reduced either outcome. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • The findings mirror similar research conducted with cisgender FSW living with HIV, which found a nearly 20% decrease in the odds of both moderate-to-severe depression and anxiety for each unit increase in mindfulness.

    “These findings mirror similar research conducted with cisgender FSW living with HIV, which found a nearly 20% decrease in the odds of both moderate-to-severe depression and anxiety for each unit increase in mindfulness. 23”

    From Mindfulness, Mental Health, and Violence Exposure Among Transgender Female Sex Workers Living with HIV in the Dominican Republic. (2026) · cites this paper as [23]

    The Results (Factors associated with mental health outcomes; page unavailable) report lower odds of moderate-to-severe depression with greater mindfulness in both countries (AOR 0.82 and 0.85), and lower odds of anxiety in the Dominican Republic (AOR 0.83)—roughly 15–18% lower odds per unit. The anxiety association was not found in Tanzania. The Methods (Measures; page unavailable) classify anxiety as borderline abnormal or abnormal, not moderate-to-severe, and the passages do not establish that participants were cisgender. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • FSW face high rates of verbal, physical, and sexual abuse from a variety of perpetrators, which can harm their mental health.

    “FSW face high rates of verbal, physical, and sexual abuse from a variety of perpetrators,5,36,45–47 which can harm their mental health.23,45”

    From Mindfulness, Mental Health, and Violence Exposure Among Transgender Female Sex Workers Living with HIV in the Dominican Republic. (2026) · cites this paper as [23]

    The Methods (Measures; page not supplied) assess physical and sexual violence by intimate partners and clients. The Results (Characteristics of the samples; Factors associated with mental health outcomes; pages not supplied) report recent sexual partner violence in 20.2% of the Dominican Republic sample and 33.2% of the Tanzania sample, and an association with greater odds of depression. The paper does not establish the claim about verbal abuse, and its mental-health finding is an association among FSW living with HIV in these two settings, not evidence that abuse caused harm across FSW generally. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Cited by

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Authors
Kerrigan, D., Karver, T. S., Barrington, C., Donastorg, Y., Perez, M., Gomez, H., Mbwambo, J., Likindikoki, S., Davis, W., Wilson Beckham, S., Mantsios, A., Galai, N., & Sibinga, E.
Affiliations
  • George Washington University (US)
  • Johns Hopkins University (US)
  • University of North Carolina at Chapel Hill (US)
  • Instituto Dermatológico y Cirugía de Piel "Dr. Huberto Bogaert Díaz" (DO)
  • Muhimbili University of Health and Allied Sciences (TZ)
Corresponding author
Mantsios, Andrea
ORCID
Venue
AIDS and Behavior
Publisher
Springer Science and Business Media LLC
Published
2021-01-28
Volume
25
Issue
9
Pages
2941-2950
ISSN
  • 1090-7165 (ISSN-L)
  • 1573-3254
DOI
10.1007/s10461-021-03168-1
PMC
PMC8316480
OpenAlex
W3125007195
Cited by
25
References
11
Citations by year
2026: 4 · 2025: 4 · 2024: 1 · 2023: 7 · 2022: 7 · 2021: 2
FWCI
5.89
Type
journal article
Language
en
Open access
Licence
Locations
  • AIDS and Behavior (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01 MH110158)
Topics
  • Social Sciences › Sociology and Political Science › Sex work and related issues
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords
mindfulness, female sex workers, HIV, depression, anxiety, antiretroviral therapy adherence, viral suppression, HIV stigma, mental health, Dominican Republic, Tanzania
MeSH terms
Cross-Sectional Studies, Dominican Republic, Female, Humans, Mental Health, Tanzania, HIV Infections, Sex Workers, Mindfulness

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