"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

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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