HIV care, prevention, and sexual and reproductive rights of migrants female sexual workers from Venezuela living in the Dominican Republic

Abstract

This study aims to identify the elements of vulnerability of Venezuelan female sex workers (FSW) and the existing obstacles in their search for sexual and reproductive health care in Santo Domingo and Puerto Plata. A mixed-methods study design was employed consisting of four focus group discussions with 2-7 participants per group. A cross-sectional quantitative survey was administered to a small sample (n=40) of Venezuelan female sex workers. Focus group discussions were analyzed using thematic content analysis to identify key themes related to the study objectives. Quantitative data were analyzed using univariate frequency and descriptive analysis. Key themes that emerged from the focus group discussions included legal status and its implication on access to health services and formal employment, mental well-being, and quality of life in the DR, navigating sex work, perceptions of sex work, sexual and reproductive health knowledge, and limited social support. Results from the quantitative analysis indicated that the majority of participants struggled with depression (79%), loneliness and isolation (75%), and difficulty sleeping (88%). Participants reported an average of 10 sexual partners in the past 30 days, 55% engaged in sexual practices while under the influence of alcohol, and only 39% had used a condom when performing vaginal, anal or oral sex in the past 30 days. Seventy-nine percent had taken HIV-test in the past 6 months and 74% knew where to seek HIV services. Most participants sought care from the public sector (68%), whilst reporting that confidentiality (100%) and receiving integrated health services (100%) were the most important factors for deciding where to seek care. This study contributes with the knowledge of migrant experiences and social exclusions by several health determinants. Results offer key insights for researchers, advocates, and policymakers working with migrant population and the development of structural and behavioral interventions. In all, aiming towards a health policy design structural and behavioral interventions to reduce HIV risk factors and improve well-being of women in the DR.