title: 'We talk, we do not have shame': addressing stigma by reconstructing identity through enhancing social cohesion among female sex workers living with HIV in the Dominican Republic.
abstract: This study explores social cohesion as a strategy used by female sex workers to address layered HIV and sex work-related stigma. Data derive from a thematic analysis of 23 in-depth interviews and 2 focus groups with female sex workers living with HIV enrolled in a multi-level HIV/STI prevention, treatment and care intervention in Santo Domingo, Dominican Republic. Drawing on Foucault's conceptualisation of modern power, discipline and resistance, we argue that social cohesion provides the psychosocial space (of trust, solidarity and mutual aid) to subvert oppressive societal norms, enabling the reconstruction of identity. Among study participants, identity reconstruction happened through the production, repetition and performance of new de-stigmatised narratives that emerged and were solidified through collective interaction. Findings highlight that enabling the collective reconstruction of identity through social cohesion - rather than solely attempting to change individual beliefs - is a successful approach to addressing stigma.
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Health, Behavior and Society , Baltimore , USA.|b United States Agency for International Development , Washington , USA.
authors.forename: Maria Augusta
authors.initials: MA
authors.lastname: Carrasco
authors.affiliation: c Department of Health Behavior, Gillins School of Global Public Health , University of North Carolina , Chapel Hill , USA.
authors.forename: Clare
authors.initials: C
authors.lastname: Barrington
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Health, Behavior and Society , Baltimore , USA.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Kennedy
authors.affiliation: d Instituto Dermatológico y Cirugía de Piel Dr. Huberto Bogaert Díaz, HIV Vaccince Research Unit , Santo Domingo , Dominican Republic.
authors.forename: Martha
authors.initials: M
authors.lastname: Perez
authors.affiliation: d Instituto Dermatológico y Cirugía de Piel Dr. Huberto Bogaert Díaz, HIV Vaccince Research Unit , Santo Domingo , Dominican Republic.
authors.forename: Yeycy
authors.initials: Y
authors.lastname: Donastorg
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Health, Behavior and Society , Baltimore , USA.
authors.forename: Deanna
authors.initials: D
authors.lastname: Kerrigan
mesh_terms: D000328:Adult; D004293:Dominican Republic; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D007407:Interviews as Topic; D036301:Qualitative Research; D012657:Self-Help Groups; D060386:Sex Workers / Q000523:psychology*; D012752:Shame; D057545:Social Stigma
keywords: Dominican Republic; Stigma; female sex workers; people living with HIV; resistance; social cohesion