“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

Author:

Payán Denise Diaz12ORCID,Derose Kathryn Pitkin2,Fulcar María Altagracia3,Farías Hugo4,Palar Kartika5

Affiliation:

1. Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA, USA

2. RAND Corporation, Santa Monica, CA, USA

3. United Nations World Food Programme, Dominican Republic Country Office, Santo Domingo, Dominican Republic

4. United Nations World Food Programme, Regional Office for Latin America and the Caribbean, Panamá, Dominican Republic

5. School of Medicine, University of California, San Francisco, San Francisco, CA, USA

Abstract

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.

Funder

National Institute of Diabetes and Digestive and Kidney Diseases

Publisher

SAGE Publications

Subject

Infectious Diseases,Dermatology,Immunology

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