Stigmas experienced by sexual and gender minority people with HIV in the Dominican Republic: a qualitative study.
Henna Budhwani, Ingrid Ruiz De León, John Waters, Princess Nash, Christyenne L Bond, Nelson Varas-Díaz, Sylvie Naar, Laura Nyblade, Robert Paulino-Ramírez, Janet M Turan
Author Information
Henna Budhwani: College of Nursing, Florida State University (FSU), Tallahassee, FL 32306, United States. ORCID
Ingrid Ruiz De León: Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Research Hub, Santo Domingo 22333, Dominican Republic.
John Waters: Caribbean Vulnerable Communities Coalition (CVC), Kingston 10, Jamaica.
Princess Nash: School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL 35233, United States.
Christyenne L Bond: College of Nursing, Florida State University (FSU), Tallahassee, FL 32306, United States.
Nelson Varas-Díaz: Department of Global and Sociocultural Studies, Florida International University, Miami, FL 33199, United States.
Sylvie Naar: Center for Translational Behavioral Science, College of Medicine, Florida State University (FSU), Tallahassee, FL 32310, United States. ORCID
Laura Nyblade: Global Health Division, International Development Group, Research Triangle Institute (RTI) International, Research Triangle Park, NC 35124, United States.
Robert Paulino-Ramírez: Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Research Hub, Santo Domingo 22333, Dominican Republic.
Janet M Turan: School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL 35233, United States.
BACKGROUND: As part of a study to test the feasibility and acceptability of the Finding Respect and Ending Stigma around HIV (FRESH) intervention to reduce stigmas and improve HIV viral suppression, our team collected qualitative data from men who have sex with men (MSM) with HIV, transgender women with HIV, and HIV healthcare providers for their perspectives on different stigmas in Dominican Republic healthcare settings. PURPOSE: We aimed to develop an understanding of the causes, consequences, and domains of stigma among sexual and gender minorities with HIV in Dominican Republic HIV clinics. METHODS: Data collection occurred in Santo Domingo and Santiago (2020-2021) and included four focus groups with MSM with HIV (n = 26), in-depth interviews with transgender women with HIV (n = 14), and in-depth interviews with HIV healthcare providers (n = 16). All data collection occurred in person and was audio recorded. Standardized guides were used for focus groups and in-depth interviews. Using a deductive process, 2 research associates thematically coded data in the NVivo software. RESULTS: On average, focus groups were 81 minutes, provider in-depth interviews were 24 minutes, and transgender women in-depth interviews were 32 minutes. We identified 4 key themes that mapped to 4 domains of stigma affecting MSM and transgender women with HIV: migrant stigma, religious stigma, sexual and gender minorities (SGM) stigma, and HIV stigma. All participant types noted the persistence of stigma and discrimination in healthcare settings in the Dominican Republic. The consequences of these stigmas were reported as being significant, including attempted suicide. CONCLUSIONS: Interventions to reduce stigma experienced by SGM populations with HIV should address structural barriers, including inner and outer contexts of HIV care provision and cultural norms and values that propagate stigma. Findings offer insights about which stigmas could be targeted in future studies and how to potentially address stigma to improve population health in the Dominican Republic.
