"It Was as Though My Spirit Left, Like They Killed Me"

The Disruptive Impact of an HIV-Positive Diagnosis Among Women in the Dominican Republic

Published in: Journal of the International Association of Providers of AIDS Care (JIAPAC), Volume 18, pages 1-10 (2019). doi: 10.1177/2325958219849042

Posted on RAND.org on October 15, 2019

by Denise Diaz Payan, Kathryn Pitkin Derose, Maria Altagracia Fulcar, Hugo Farias, Kartika Palar

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An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. Few studies have explored the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings. We conducted in-depth interviews with 30 women living with HIV in the Dominican Republic. Interviews were audio-recorded, transcribed, and analyzed using the biographical disruption framework. Three disruption phases emerged (impacts of a diagnosis, postdiagnosis turning points, and integration). Nearly all respondents described the news as deeply distressful and feelings of depression and loss of self-worth were common. Several reported struggling with the decision to disclose—worrying about stigma. Postdiagnosis turning points consisted of a focus on survival and motherhood; social support (family members, friends, HIV community) promoted integration. The findings suggest a need for psychological resources and social support interventions to mitigate the negative impacts of an HIV diagnosis.

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