title: Abriendo Puertas: Feasibility and Effectiveness a Multi-Level Intervention to Improve HIV Outcomes Among Female Sex Workers Living with HIV in the Dominican Republic.
abstract: Female sex workers (FSW) are disproportionately affected by HIV. Yet, few interventions address the needs of FSW living with HIV. We developed a multi-level intervention, Abriendo Puertas (Opening Doors), and assessed its feasibility and effectiveness among a cohort of 250 FSW living with HIV in the Dominican Republic. We conducted socio-behavioral surveys and sexually transmitted infection and viral load testing at baseline and 10-month follow-up. We assessed changes in protected sex and adherence to antiretroviral therapy (ART) with logistic regression using generalized estimating equations. Significant pre-post intervention changes were documented for adherence (72-89 %; p < 0.001) and protected sex (71-81 %; p < 0.002). Higher intervention exposure was significantly associated with changes in adherence (AOR 2.42; 95 % CI 1.23-4.51) and protected sex (AOR 1.76; 95 % CI 1.09-2.84). Illicit drug use was negatively associated with both ART adherence and protected sex. Abriendo Puertas is feasible and effective in improving behavioral HIV outcomes in FSW living with HIV.
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, 624 N Broadway HH 257, Baltimore, MD, 21205, USA. dkerrig1@jhu.edu.
authors.forename: Deanna
authors.initials: D
authors.lastname: Kerrigan
authors.affiliation: The University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
authors.forename: Clare
authors.initials: C
authors.lastname: Barrington
authors.affiliation: Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic.
authors.forename: Yeycy
authors.initials: Y
authors.lastname: Donastorg
authors.affiliation: Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic.
authors.forename: Martha
authors.initials: M
authors.lastname: Perez
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, 624 N Broadway HH 257, Baltimore, MD, 21205, USA.|Department of Statistics, The University of Haifa, Mt Carmel, Israel.
authors.forename: Noya
authors.initials: N
authors.lastname: Galai
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D055812:Community-Based Participatory Research; D004293:Dominican Republic / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy* / Q000821:virology; D006801:Humans; D016015:Logistic Models; D055118:Medication Adherence; D040242:Risk Reduction Behavior; D021841:Safe Sex / Q000706:statistics & numerical data*; D060386:Sex Workers / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D019562:Viral Load
keywords: HIV; Multi-level intervention; Protected sex; STI; Sex workers; Viral suppression