| Autor: |
Wang Y; Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA., Berg CJ; Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA., Donastorg Y; Instituto Dermatológico y Cirugía de la Piel, Santo Domingo, Dominican Republic., Perez M; Instituto Dermatológico y Cirugía de la Piel, Santo Domingo, Dominican Republic., Gomez H; Instituto Dermatológico y Cirugía de la Piel, Santo Domingo, Dominican Republic., Karver TS; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Galai N; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.; The Department of Statistics, University of Haifa, Mt Carmel, Israel., Sibinga E; Johns Hopkins University School of Medicine, Baltimore, MD, USA., Barrington C; Department of Health Behavior, Gillings School of Global Public Health, Chapel Hill, NC, USA., Kerrigan D; Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. |
| Abstrakt: |
Female sex workers (FSW) living with HIV experience greater depression and worse HIV outcomes than people living with HIV (PLHIV) overall. Mindfulness is related to lower depression and higher ART adherence in PLHIV. Few studies have assessed these relationships among FSW, especially longitudinally. This study assessed the temporal relationship between mindfulness, mental health and HIV outcomes among FSW from the Dominican Republic (DR). We analyzed data collected between 2018 and 2021 among 240 FSW using mixed modeling to assess contemporaneous relationships and time-lagged relationships between mindfulness and mental health (i.e., depression,HIV stigma, drug and alcohol use ), and HIV outcomes (i.e., ART adherence, viral suppression) , accounting for clustering of repeated measures. Greater mindfulness showed contemporaneous and time-lagged associations with lower depression (contemporaneous: b = -0.57, SE = 0.03, p < 0.001; time-lagged: b = -0.16, SE = 0.05, p < 0.001), lower HIV stigma (contemporaneous: b = -0.11, SE = 0.02, p < 0.001; time-lagged: b = -0.08, SE = 0.03, p = 0.003) and higher ART adherence (contemporaneous: b = 0.03, SE = 0.01, p = 0.003; time-lagged: b = 0.04, SE = 0.01, p = 0.004), and contemporaneous associations with reduced at-risk alcohol use and higher viral suppression (aOR = 0.99, 95% CI = 0.99-1.00, p = 0.003; aOR = 1.01, 95% CI: 1.00-1.01, p = 0.036, separately). Mindfulness instruction is a promising intervention for reducing depression and HIV stigma, and promoting better HIV outcomes among FSW living with HIV, meriting future intervention research in this area. |
