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 language | English |
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Pages (from-to) | 2079-2088 |
Number of pages | 10 |
Journal | AIDS and Behavior |
Volume | 27 |
Issue number | 7 |
DOIs | |
State | Published - Jul 2023 |
Bibliographical note
Publisher Copyright:© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Keywords
- ART adherence
- Depression
- HIV
- Sex work
- Substance use
ASJC Scopus subject areas
- Social Psychology
- Public Health, Environmental and Occupational Health
- Infectious Diseases