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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Cabarets/casas de citas are bars and brothels that employ women to sell alcoholic drinks, dance with customers, and provide sexual services. Female employees may or may not live on the premises.
Women who engage in car wash-based sex work, work in carwashes with on-site bars staffed by sex workers available for hire.
Escort resorts are adults-only resorts staffed by sex workers available for hire.
Independent sex workers are sex workers who are not formally employed by any particular business. Typically, these women work on a freelance basis on the street, from their homes, or in local bars.
References
Abadía-Barrero, C. E., & Castro, A. (2006). Experiences of stigma and access to HAART in children and adolescents living with HIV/AIDS in Brazil. Social Science and Medicine, 62(5), 1219–1228.
Brennan, D. (2004a). What’s love got to do with it? Transnational desires and sex tourism in the Dominican Republic. Durham: Duke University Press.
Brennan, D. (2004b). Women work, men sponge, and everyone gossips: Macho men and stigmatized/ing women in a sex tourist town. Anthropological Quarterly, 77(4), 705–733.
Brown, L., Macintyre, K., & Trujillo, L. (2003). Interventions to reduce HIV/AIDS stigma: What have we learned? AIDS Education and Prevention, 15(1), 49–69.
Cabezas, A. (1999). This is a chapter. In K. Kempadoo (Ed.), Sun, sex, and gold: Tourism and sex work in the Caribbean (pp. 93–122). Lanham, MD: Roman and Littlefield Publishers Inc.
Codigo Penal de la República Dominicana. (2014). Santo Domingo, República Dominicana. Retrieved from: http://www.oas.org/juridico/spanish/mesicic2_repdom_sc_anexo_21_sp.pdf.
Consejo Presidencial de SIDA (COPRESIDA). (2008). Iera Encuesta de Vigilancia de Comportamiento con Vinculación Serológica en Poblaciones Vulnerables. República Dominicana: Santo Domingo.
Crocker, J., Major, B., & Steele, C. (1998). Social stigma. In D. T. Gilbert & S. T. Fiske (Eds.), The handbook of social psychology (Vol. 2, pp. 504–553). Boston: McGraw-Hill.
Donastorg, Y., Barrington, C., Perez, M., & Kerrigan, D. (2014). Abriendo Puertas: Baseline findings from an integrated intervention to promote prevention, treatment and care among FSW living with HIV in the Dominican Republic. PLoS ONE, 9(2), 1–9.
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York, NY: Simon and Schuster Inc.
Kalichman, S. C., Leickness, S. C., Allanise, C., Phumelele, M. P., Ruth, M. N., & Themba, G. (2009). Measuring AIDS stigmas in people living with HIV/AIDS: The internalized AIDS-Related Stigma Scale. AIDS Care, 21(1), 87–93.
Kerrigan, D., Moreno, L., Rosario, S., & Sweat, M. (2001). Adapting the Thai 100% condom programme: Developing a culturally appropriate model for the Dominican Republic. Culture, Health and Sexuality, 3(2), 221–240.
LaVeist, T. A., Rolley, N. C., & Diala, C. (2003). Prevalence and patterns of discrimination among U.S. health care consumers. International Journal Health Services, 33(2), 331–344.
Leclerc, L. I. (2014, Octubre 28). Vence Hoy Plazo de la Ley de Naturalización. Listin Diario. Retrieved from: http://www.listindiario.com/.
Liu, S. H., Srikrishnan, A. K., Zelaya, C. E., Solomon, S., Celentano, D. D., & Sherman, S. G. (2011). Measuring perceived stigma in female sex workers in Chennai, India. AIDS Care, 23(5), 619–627.
Mayorga, L., & Velásquez, P. (1999). This is a chapter. In K. Kempadoo (Ed.), Sun, sex, and gold: Tourism and sex work in the Caribbean (pp. 93–122). Lanham, MD: Roman and Littlefield Publishers Inc.
Miller, S., Lehman, T., Campbell, M., Hemmering, A., Brito Anderson, S., Rodriguez, H., et al. (2005). Misoprostol and declining abortion-related morbidity in Santo Domingo, Dominican Republic: A temporal association. BJOG: An International Journal of Obstetrics and Gynaecology, 112(9), 1291–1296.
Nyblade, L. (2006). Measuring HIV stigma: Existing knowledge and gaps. Psychology, Health and Medicine, 11(3), 335–345.
Parker, R., & Aggleton, P. (2003). HIV and AIDS-related stigma and discrimination: A conceptual framework and implications for action. Social Science and Medicine, 57, 13–24.
Scambler, G., & Paoli, F. (2008). Health work, female sex workers, and HIV/AIDS: Global and local dimensions of stigma and deviance as barriers to effective interventions. Social Science and Medicine, 66(8), 1848–1862.
USAID. (2012). Demographics and health survey—Woman’s Questionnaire. Calverton, Maryland: ICF International. Retrieved from: http://dhsprogram.com/pubs/pdf/DHSQ6/DHS6_Questionnaires_5Nov2012_DHSQ6.pdf.
Vanwesenbeeck, I. (2001). Another decade of social scientific work on sex work: A review of research 1990–2000. Annual Review of Sex Research, 12, 242–289.
Weiss, M., Ramakrishna, J., & Somma, D. (2006). Health-related stigma: Rethinking concepts and interventions. Psychology Health and Medicine, 11(3), 277–287.
World Health Organization. (2002a). World health survey A—Household Questionnaire. Retrieved from: http://www.who.int/healthinfo/survey/whslonghouseholdlow.pdf.
World Health Organization. (2002b). World health survey B—Individual Questionnaire. Retrieved from: http://www.who.int/healthinfo/survey/whslongindividuala.pdf.
Acknowledgments
This project was supported by a Fulbright Program grant sponsored by the Bureau of Educational and Cultural Affairs of the United States Department of State and administered by the Institute of International Education. Data collection support was provided by Yasmín Soto and María del Rosario Martinez-Muñoz. Special thanks to Centro de Promoción y Solidaridad Humana (CEPROSH) and Grupo Clara, who provided the local infrastructure for outreach and study subject recruitment.
Conflict of interest
None.
Ethical standard
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rael, C.T. Perceptions of Sex Work-Related Stigma in Female Sex Workers from the Dominican Republic: Implications for HIV Interventions. Sexuality & Culture 19, 674–684 (2015). https://doi.org/10.1007/s12119-015-9284-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12119-015-9284-3