“A normal part of life”: Experiences of violence among transgender women sex workers with HIV in the Dominican Republic

Background Transgender and other gender diverse (trans) women experience pervasive violence, but there is limited research on the experiences of trans women in Latin America and the Caribbean. To inform prevention and support efforts, there is a need for contextualized understanding of violence.Purpose We characterized violence experienced by trans women sex workers with HIV in the Dominican Republic. Specifically, we explored how violence occurs across types of perpetrators and how trans women prevent or respond to violence.Methods In 2019, we conducted 21 in-depth interviews with trans women sex workers with HIV in Santo Domingo, DR. Participants were recruited through peer navigators and referrals. Interviews were conducted in Spanish, audio-recorded and transcribed verbatim, and analyzed using narrative and thematic techniques.Results Violence was a “normal part of life” that was described as occurring due to having multiple and intersectional stigmatized identities and experiences, especially related to being trans, doing sex work, and living with HIV. Participants described multiple perpetrators including strangers, police, sex work clients, families, classmates and school staff, and healthcare workers. There was variation in the nature of violence across perpetrators; however, institutional structures (e.g. criminal justice, education, and healthcare systems) consistently contributed to violence.Discussion There is a need for structural, institutional, and community level interventions to address the root causes of violence. This can include stigma-reduction interventions, anti-discrimination policies, efforts to enhance police accountability, or anti-violence movements based on collective community action.