The Role of Mobility in HIV Intervention Engagement and Community Mobilization among Female Sex Workers Living with HIV in the Dominican Republic

Female sex workers (FSWs) are often a mobile population, but the role of mobility in influencing FSW social capital outcomes-defined here as engagement with HIV intervention activities and community mobilization-remains unclear. To date, the evidence is mixed, with mobility both facilitating and hindering community engagement, depending on the context. This study is the first to employ a mixed-methods approach to examine how mobility impacts these outcomes. We combined baseline survey data from 211 FSWs living with HIV with semi-structured interview data from a sub-cohort of 20 FSWs in Santo Domingo, Dominican Republic. Contrary to the expectation that mobility would reduce engagement, our quantitative findings indicate that mobile FSWs were more likely to participate in various HIV interventions, such as support groups for people living with HIV, compared to their non-mobile counterparts. Additionally, mobile women were more than twice as likely to engage in community mobilization efforts, such as rallies to promote sex worker rights, even after controlling for sociodemographic variables. Many participants, despite their mobility, shared that they actively engaged in HIV-related and community mobilization activities in Santo Domingo and gained benefits from these activities. Study implications highlight the need for more sex worker-driven activities in and outside of Santo Domingo to offer mobile women greater opportunities to connect and build social cohesion, as well as the development of mobile-friendly service delivery models and apps to facilitate connections when traveling outside the capital.