Transgender Women's Drug Use in the Dominican Republic

Abstract

Purpose: Studies on drug use in transgender populations, particularly those in resource-limited settings, are scarce. Considering that drug use can be a coping mechanism to deal with stigma and traumatic experiences, we examined associations between stigma, trauma, and drug use in a national sample of transgender women from the Dominican Republic.Methods: Bivariate analyses examined differences between drug users and abstainers (n=287). Multivariate analyses reported odds ratios (OR) with general drug, marijuana, and cocaine use as outcomes (n=243).Results: A quarter of respondents (24.5%) experienced sexual abuse, 12.1% were tortured, and 20.1% experienced a murder attempt. More than a quarter reported using illegal drugs (26.1%). Drug users had lower socioeconomic status; 30.0% of drug users had a primary level of education or less (18.2% of abstainers) and 17.6% of drug users had higher income, defined as greater than 10,001 pesos (∼$210 United States Dollars, USD) per month (28.1% of abstainers). More than half of drug users experienced some form of trauma (51.4%) compared to 43.5% of abstainers, and 28.4% of drug users, compared to 17.1% of abstainers, experienced a murder attempt on her life. Independent sample t-tests found significant differences between drug users and abstainers. Transgender women who experienced sexual abuse had three times high odds of using cocaine. Drug users were more likely to have experienced sexual abuse and attempted suicide (p<0.05 for both). Respondents who attempted suicide had higher odds of using drugs generally and using marijuana specifically, compared to respondents who had not attempted suicide (OR=2.665 and 3.168, respectively). Higher scores on the stigma scale were associated with higher odds of any drug use and cocaine use (OR=1.132 and 1.325, respectively).Conclusions: Although some nations have implemented antidiscrimination policies protecting transgender citizens, these policies are not consistently enforced. Eliminating stigma and stigmatizing policies may reduce rates of drug use as a coping mechanism.

Transgender female sex workers’ HIV knowledge, experienced stigma, and condom use in the Dominican Republic

“…[ 44 – 49 ] Experienced stigma, discrimination and physical violence may reduce the likelihood of condom use, increase engagement in highly risky sexual behaviors, and in turn, increase rates of HIV and STIs in transgender populations. [ 21 , 44 – 45 , 48 – 49 ] The vulnerabilities experienced by transgender persons, especially transgender persons in resource-constrained settings such as in the Dominican Republic, could be partially addressed through understanding of impact of policies that indirectly promote or allow harm to transgender citizens and subsequently diminish the effectiveness of public health and education interventions that are funded both by domestic and global agencies that seek to contain the HIV epidemic. [ 44 ] By taking these actions through the revocation of such laws and making these societally relevant commitments, the Dominican Republic has the opportunity to improve overall population health, to protect some of its most stigmatized citizens, and to become the flag bearer of enhanced human rights in the Caribbean and Latin America.…”

Human T-cell lymphotropic virus 1/2 and human immunodeficiency virus antibodies identification among transactional sex workers and drug users in the Dominican Republic

“…28 Consequently, this chronic immune activation may induce prominent metabolic complications. [28][29][30] Therefore it is all the more important to consider the long-term implications of this co-infection, particularly in highprevalence countries such as the Dominican Republic, and to demystify the associated complications. Results also call attention to the need for more investigations on the neurological complications experienced, to show the clinically relevant effect of HTLV-1 and HTLV-2 on HIV-1-positive patients.…”

Female Sex Workers’ Experiences of Violence and Substance Use on the Haitian, Dominican Republic Border

“…Informed by findings from global studies with FSWs and Goffman's conception of stigma wherein the "other" (in this case, Haitian FSWs in the Dominican Republic) may be societally devalued leading to increased negative exposures and outcomes, we hypothesize that Haitian FSWs in the Dominican Republic will have higher odds of being physically abused by sexual partners as compared to Haitian FSWs in Haiti. We also hypothesize that these experiences of violence and abuse will be associated with substance use, a well-documented method to cope with trauma and distress [7][8][9].…”