Developing a Community-Led Mindfulness Instruction Intervention to Improve Mental Health and HIV Outcomes Among Female Sex Workers in the Dominican Republic

Mindfulness interventions can improve mental health and medication adherence, with most led by non-community members. Community-led approaches are considered best practice among female sex workers (FSW). We describe the development and initial piloting of a community-based mindfulness intervention with FSW in the Dominican Republic (DR).

Formative interview participants described HIV and sex work stigma as stressors leading to poor mental health and HIV outcomes. Mindfulness practices were found to help alleviate stressors and improve adherence to antiretroviral therapy. Peer leaders from the community-based mindfulness intervention pilot found it to be beneficial, reporting the methods learned provided them with tools to cope with stressors. Participants specifically highlighted improvements in mental health (lower stress, anxiety and depression), less pain and better sleep, and improved adherence to ART; almost all CAMS-R items improved. All peer leaders were interested in being trained as facilitators and offered suggestions to improve intervention accessibility.

This community-based mindfulness intervention with FSW shows promise for improving mental health and HIV outcomes, meriting further implementation and evaluation.