Perceptions of Sex Work-Related Stigma in Female Sex Workers from the Dominican Republic: Implications for HIV Interventions

Abstract

Stigma is an important obstacle that affects access to health resources for groups vulnerable to HIV, such as female sex workers (FSW). Experiences and types of stigma are diverse, and vary across cultural settings. Consequently, research that places stigma within appropriate socio-cultural contexts should be the first step towards developing effective HIV-prevention interventions. This study examined the stigma related to engaging in sex work in a group of FSW in the Dominican Republic. The present investigation used the Sex Worker Stigma (SWS) Index to identify factors associated with sex work-related stigma along two perceived stigma domains: the community and family. A verbally administered, tablet-based questionnaire was completed by 338 FSW. Results indicate that multiple independent factors influence perceived sex work-related stigma from community and family sources. FSW who engage in sex work on an independent basis, Haitian FSW, and women who live in the same household as their dependent children perceive less sex work-related stigma from the community. Conversely, FSW who spend more time engaged in sex work per week perceive more sex work-related stigma from this source. Within the family domain, women who live in the same household as their dependent children and FSW with higher levels of education perceive less stigma from family members. FSW who provide the principal household economic support perceive more sex work-related stigma from family members. Findings show that sex work-related stigma is unique and should be taken into account for interventions focused on HIV prevention and/or stigma in female sex workers.

Understanding internalized HIV/AIDS-related stigmas in the Dominican Republic: a short report

“…al., 2012; UNAIDS, 2002). FSW in the DR report perceived stigma related to their occupation from their home communities and families (Rael, 2015). Therefore, sex work may increase IS in WLWHA due to the stigma associated with their profession (Kennedy, et.…”

“…Therefore, sex work may increase IS in WLWHA due to the stigma associated with their profession (Kennedy, et. al., 2013; Brennan, 2004; Rael, 2015) and their HIV status. We also expect that WLWHA who report worse depression will have higher IS.…”

A Systematic Review of Factors Influencing Condom Use among Female Sex Workers

“…As the literature shows, it is not the act of exchanging sex for money that damages the physical and psychological integrity of the FSW, but the stigmatization to which they are subjected (Comte, 2013). Stigma is one of the main barriers to accessing health services, with marginalized groups fearing discrimination and rejection from institutions and individuals (Rael, 2015). Some FSWs have described feelings the pressure to fit into society and hide their profession in order to receive the services to which they are entitled (Yingwana, 2018).…”

Intersectional Stigma, Identity, and Culture: A Grounded Theory of Female Escort Perspectives from Brazil and Pakistan

“…Governance structures contain no laws forbidding adult sex work, indeed Ordinance 397 recognised sex work as an 'official' occupation with those registered as 'sex professionals' taxed as autonomous workers and entitled to regular employment benefits including maternity pay, a state pension fund and medical care (De Lisio, 2017). While this increased social tolerance was tested in the moral panics in the lead up to the FIFA World Cup in 2014 and the Rio Olympic Games in 2016 tolerance remains part of the fabric of Brazilian culture despite perceptions of stigma more broadly in Latino/a culture (Rael, 2015). Governance is also underpinned by a strong sex worker movement in the measure against HIV has become increasingly difficult particularly because of prevalent illiteracy, thus increasing their vulnerability to HIV infection and STIs.…”

“…Due to the discrimination and stigmatization of sex workers they remain under-represented, over-judged and live their lives with little or no support. Research carried out on support and stigma with sex workers has focused on health-related issues with regards to the prevalence, transmission and seeking of help for HIV and sexually transmitted diseases (eg: Day and Ward, 1997;Brown at al, 2003;Duffy, 2005;Scambler and Paoli, 2008) as one of the fundamental impacts of stigma is the restricted access to health services (Bodkin et al, 2015;Rael 2015;King et al, 2013;Scorgie et al, 2013;Lazarus et al, 2012). This is an issue of growing importance in a global pandemic era.…”