article · Culture Health & Sexuality
Initial measures to curb the COVID-19 pandemic through movement restrictions created economic insecurity and disrupted chronic health care management, including HIV care. A study examined how female sex workers living with HIV in the Dominican Republic and Tanzania adapted during the onset of the pandemic and how lockdown measures affected their treatment. Analysis of forty interviews across both countries revealed that fear and financial insecurity were the primary impacts of early lockdown policies. Although the women encountered severe difficulties in accessing HIV-related medical care and received little or no state social protection, they managed to maintain medication adherence and wellbeing. They achieved this by relying on personal resilience alongside support from families and local communities. The findings indicate an urgent requirement for robust, state-level social safety nets to mitigate economic shocks and reinforce community and personal support networks during major public health emergencies.
During major health emergencies, movement restrictions can compromise the regular care required for chronic conditions such as HIV. Understanding how marginalised groups, such as female sex workers, cope in distinct global contexts helps public health planners design stronger social protections. Relying solely on informal community support is unsustainable, making structured safety nets essential to protect vulnerable populations during disruptions.
The abstract does not indicate an application pathway for commercialisation, as it presents qualitative public health research focused on policy and social protection programmes rather than a commercial product or service.
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Initial efforts to control COVID-19 included restricting human movement, which caused heightened economic insecurity and challenges to the management of chronic health conditions such as HIV. The aims of this study were to: (1) explore how female sex workers living with HIV in the Dominican Republic and Tanzania, two different cultural and epidemic contexts, reacted to the onset of the COVID-19 pandemic, and (2) assess how lockdown measures impacted HIV care and treatment experiences. We analysed data from interviews (20 in each country) conducted during the onset of the COVID-19 pandemic as part of a longitudinal study of the social determinants of HIV outcomes. Using narrative and thematic analytic techniques, we identified fear and financial insecurity as the two main impacts of the initial COVID-19 lockdown on female sex workers in both settings. While participants experienced challenges accessing HIV-related care and treatment and received limited to no state-level social protection, they adapted to these changes by drawing on individual resilience and family and community support to sustain adherence to medication and overall wellbeing. Findings highlight the need for systems-level social protection to reduce economic insecurity prior to shocks and bolster individual resilience, family, and community-level supports during crises such as COVID-19.
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DOI: 10.1080/13691058.2025.2493132
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