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Understanding The HIV Epidemic In The Dominican Republic: A Prevention Success Story In The Caribbean?

Daniel T Halperin, E. A. de Moya, E. Pérez-Then, Gregory S. Pappas, Jesus M Garcia Calleja
Published 2009 · Medicine

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Objective: To analyze the general dynamics and trends of the HIV epidemic in the Dominican Republic (DR). Methods: Thorough review of available HIV seroprevalence and sexual behavioral data from the DR. Results: Multiple sources of data suggest that the DR's HIV epidemic has generally declined. Between the mid-1990s and about 2002, HIV-1 prevalence fell among pregnant women in the capital, Santo Domingo, particularly among young women. Declines in prevalence were also observed over the same period among sexually transmitted infection clinic patients, blood bank donors, US entry visa applicants, and female sex workers. National household surveys found 1.0% (confidence interval: 0.9% to 1.1%) adult prevalence in 2002 and 0.8% (0.6% to 0.9%) in 2007. Among largely Haitian immigrant residents of the impoverished former “sugarcane plantations,” prevalence was much higher but declined from 5.0% to 3.2% between 2002 and 2007. The DR's heterogeneous epidemic includes an important men-having-sex-with-men (MSM) and bisexual component. The proportion of reported AIDS cases among men remained constant from 1989 to 2006, accounting for about two thirds of both total cumulative and year 2006 cases. Some survey and qualitative data also suggest a considerable occurrence of MSM-related risk behaviors. HIV prevalence remains relatively high in MSM, with no evidence of significant decrease. Conclusions: As in several other developing countries that have succeeded in slowing HIV transmission, HIV reductions in the DR seem mainly due to changes in sexual behavior, particularly increased condom use, especially for sex work, and partner reduction in men. Similarly favorable HIV declines and reported behavior change have occurred in some other Caribbean countries, including neighboring Haiti. However, of concern is that anal sex, both male-male and heterosexual, remains a taboo yet apparently common practice largely ignored by existing prevention campaigns. And although the DR epidemic has generally stabilized, there is a danger of complacency, and some recent data suggest that HIV prevalence is no longer declining (and may even be increasing) in some populations.
This paper references
Cancer Stress Continues
R. Voelker (2001)
Actitudes y comportamiento sexual en hombres de 18-27 años en Santo Domingo
M M Frias (1987)
Prevalence of antibodies to the human immunodeficiency virus in Dominicans and Haitians in the Dominican Republic.
R. Koenig (1987)
Understanding the reasons for decline of HIV prevalence in Haiti
E. Gaillard (2006)
Evaluating the risk of HIV transmission through unprotected orogential sex. AIDS
J del Romero (2002)
Demographic and health surveys
A. Blanc (1991)
Evaluating an Adolescent-Targeted HIV Prevention Program in Haitian Migrant Communities in the Dominican Republic
Z Kaufman
The HIV epidemic in the Caribbean: meeting the challenges of achieving universal access to prevention, treatment and care.
J. Figueroa (2008)
Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I.
D. Halperin (1999)
Sexual partner reduction and HIV infection
E. C. Green (2000)
Sexual behaviors and risk factors for HIV infection among men who have sex with men in the Dominican Republic
S. Tabet (1996)
University students and AIDS: some findings from three surveys-1989, 1990, 1992. Buletin de Estudios Puertoriquenos
I Cunningham (1994)
AIDS and the enigma of bisexuality in the Dominican Republic.
de Moya Ea (1996)
National Human Development Report, the Dominican Republic
Characteristics of the acquired immunodeficiency syndrome (AIDS) in Haiti.
J. Pape (1983)
High level of HIV-1 infection from anal intercourse: a neglected risk factor in heterosexual AIDS prevention
DT Halperin (2002)
Sexual behavior and status for human immunodeficiency virus type 1 among homosexual and bisexual males in Mexico City.
M. Hernández (1992)
Partner reduction is crucial for balanced “ABC” approach to HIV prevention
J. Shelton (2004)
The HVTN Protocol 903 Vaccine Preparedness Study: Lessons Learned in Preparation for HIV Vaccine Efficacy Trials
G. Djomand (2008)
de la epidemia VIH/SIDA en la República Dominicana 2007
DIGECITSS. Estimacione (2007)
The HIV epidemic in the Caribbean meeting the challenges of achieving universal access to prevention, treatment and care
Figueroa Jp (2008)
HIV/AIDS in the Caribbean: big problems among small islands.
R. Voelker (2001)
Secretaría d Estado de Salud Pública y Asistencia Social
HIV and AIDS in the Americas: an epidemic with many faces
E Pisani (2001)
Has global HIV incidence peaked?
T. Hallett (2006)
Epidemic Crack Cocaine Use Linked with Epidemics of Genital Ulcer Disease and Heterosexual HIV Infection in the Bahamas: Evidence of Impact of Prevention and Control Measures
M. P. Gomez (2002)
Evaluation of Jamaica’s National AIDS Program. Washington, DC: USAID/TvT Associates (Synergy Project)
S Amarasingham (2000)
de Vigilancia Centinela de la Infección VIH
DIGECITSS. Sistem (2009)
Evaluation of Jamaica's National AIDS Program
S Amarasingham (2000)
Three Decades of Male Sex Work in Santo Domingo
E. M. García (2006)
HIV Prevention strategies among female sex workers in the Dominican Republic
L Moreno (2000)
The global HIV/AIDS epidemic.
C. Krulewitch (2001)
Dry sex practices and HIV infection in the Dominican Republic and Haiti.
D. Halperin (1999)
HIV seroprevalence in La Victoria Penitentiary
A Hung (1995)
Estimaciones de la epidemia VIH/SIDA en la República Dominicana
HIV infection does not disproportionately affect the poorer in sub-Saharan Africa
V. Mishra (2007)
Trabajo, salud y SIDA: compilacion de investigaciones
S Rosario (1998)
Pan American Health Organization (PAHO)/UNAIDS. Situación del VIH/ SIDA en los bateyes azucareros de Barahona
Positive sexual behavior change in the Dominican Republic
EC Green (1999)
Estudios Sociales y Demográficos. Encuesta sobre conocimientos, creencias, actitudes y prácticas acerca del VIH/SIDA en adolescentes y jóvenes
Centro de (1999)
Evaluating an Adolescent-Targeted HIV Prevention Program in Haitian Migrant Communities in the Dominican Republic. [Honors Thesis
Z. Kaufman (2008)
Bodies, pleasures and passions: sexual culture in contemporary Brazil
Coimbra (1992)
salud y SIDA: compilacion de investigaciones
S Rosario (1998)
HIV and AIDS in the Americas: an epidemic with many faces. PAHO/WHO/UNAIDS
E Pisani (2001)
University Students and AIDS: Some Findings from Three Surveys--1989, 1990 and 1992.
I. Cunningham (1994)
Population-Level HIV Declines and Behavioral Risk Avoidance in Uganda
R. Stoneburner (2004)
Why is HIV Prevalence so Severe in Southern Africa ? The role of multiple concurrent partnerships and lack of male circumcision : Implications for AIDS prevention
D. Halperin
Actitudes y comportamiento sexual en hombres de 18-27 años en Santo Domingo. Santo Domingo, Dominican Republic: Universidad Autonoma
MM Frias (1987)
Guidelines for Measuring HIV Prevalence in National Population Surveys
WhoUnaids (2005)
A global analysis of trends in the quality of HIV sero-surveillance
J. M. Garcia-Calleja (2004)
Traditional Intravaginal Practices and the Heterosexual Transmission of Disease: A Review
J. E. Brown (2000)
Has global HIV incidence peaked? Lancet
JD Shelton (2006)
Análisis de la situación y la respuesta al VIH/SIDA en República Dominicana
F Cáceres (1998)
Encuesta sobre conocimientos, creencias, actitudes y prácticas acerca del VIH/SIDA en adolescentes y jóvenes
Uganda's HIV Prevention Success: The Role of Sexual Behavior Change and the National Response
E. Green (2006)
Declines in HIV prevalence can be associated with changing sexual behaviour in Uganda, urban Kenya, Zimbabwe, and urban Haiti
T. Hallett (2006)
Reassessing HIV Prevention
M. Potts (2008)
Resultados de la ''XV Encuesta Serológica de Vigilancia Centinela Segunda Generación
Dominican Republic: PSI
Men Who Sell Sex: International Perspectives on Male Prostitution and AIDS
P. Aggleton (1998)
Global HIV prevalence: the good news might be even better
Daniel T. Halperin (2004)
AIDS and heterosexual anal intercourse
B. Voeller (1987)
Demographic and Health Surveys, Dominican Republic
CESDEMMACRO International (1991)
Proyecto Delta: Informe final. Santo Domingo, Dominican Republic: CESDEM
J Toro-Alfonso (2005)
Proyecto Delta: Informe final
J Toro-Alfonso (2005)
Encuesta sobre conocimientos, creencias, actitudes, y prácticas acerca del VIH/SIDA (quarterly report
Pilot Circumcision Project: Follow-Up and Final Evaluation Report
CreshmPsi Haiti
Evaluating the risk of HIV transmission through unprotected orogenital sex.
J. del Romero (2002)
HIV, STDs, anal sex and AIDS prevention policy in a northeastern Brazilian city
D. Halperin (1998)

This paper is referenced by
Review of the History and Current Status of Cell-Transplant Approaches for the Management of Neuropathic Pain
M. Eaton (2012)
Feasibility of Identifying a Female Sex Worker Cohort at High Risk of HIV Infection in the Caribbean for HIV Vaccine Efficacy Trials: Longitudinal Results of HVTN 907
M. M. Deschamps (2016)
Abriendo Puertas: A Multi-level Intervention to Improve HIV Outcomes by Addressing Stigma and Discrimination Among Female Sex Workers in the Dominican Republic
D. Kerrigan (2018)
Combination HIV Prevention : Tailoring and Coordinating Biomedical , Behavioural and Structural Strategies to Reduce New HIV Infections
A UNAIDS (2011)
Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis.
S. Baral (2012)
Addressing Health Disparities Among Men: Demographic, Behavioral, and Clinical Characteristics of Men Who Have Sex with Men in Puerto Rico
V. Colón-López (2013)
HIV testing, care, and treatment experiences among the steady male partners of female sex workers living with HIV in the Dominican Republic
P. Fleming (2016)
Acceptability of Male Circumcision for the Prevention of HIV/AIDS in the Dominican Republic
M. Brito (2009)
Beyond ‘state pimpage’: insights from local leaders on HIV/AIDS prevention in the Dominican tourism industry
Maureen D. Connolly (2012)
HIV Sexual Risk Behavior and Family Dynamics in a Dominican Tourism Town
V. Guilamo-Ramos (2013)
Samantha Dittrich (2012)
Phylogeographic Analyses Reveal the Early Expansion and Frequent Bidirectional Cross-Border Transmissions of Non-pandemic HIV-1 Subtype B Strains in Hispaniola
G. Bello (2019)
Women’s HIV Knowledge and Condom Use Across Diverse Relationship Types in the Dominican Republic and Haiti
J. T. Erausquin (2018)
Challenges to successful implementation of HIV and AIDS-related health policies in Cartagena, Colombia.
N. Djellouli (2015)
Psychosocial correlates of safe sex communication between Latina women and their stable male partners: an integrative review
Heidi Luft (2017)
Behavioral and Psychosocial Correlates of Anal Sex Among Male Clients of Female Sex Workers in Tijuana, Mexico
S. Semple (2015)
A multi-level examination of the experiences of female sex workers living with HIV along the continuum of care in the Dominican Republic
R. Zulliger (2018)
A Comparative Analysis of the Attitudes towards People Living with HIV/AIDS between Haiti and the Dominican Republic
G. Perrin (2010)
Sexual Relationship Power and Safe Sex Communication Among Partnered Women in the Dominican Republic
Heidi Luft (2019)
Global Perspectives on Women's Sexual and Reproductive Health Across the Lifecourse
Shonali M. Choudhury (2018)
Strategies for Recruiting Steady Male Partners of Female Sex Workers for HIV Research
Paul J. Fleming (2014)
“Todo se trata de a quién conoces”: Social Networks and Drug Use Among Female Sex Workers Living with HIV in the Dominican Republic
E. Felker-Kantor (2020)
Violence From a Sexual Partner is Significantly Associated With Poor HIV Care and Treatment Outcomes Among Female Sex Workers in the Dominican Republic
Carlisdania Mendoza (2017)
Factors Associated with Health Information Seeking, Processing, and Use Among HIV Positive Adults in the Dominican Republic
Samantha Stonbraker (2016)
Effectiveness of a sports-based HIV prevention intervention in the Dominican Republic: a quasi-experimental study
Z. Kaufman (2012)
La vida normal: living with HIV in Santo Domingo, Dominican Republic
C. Barrington (2018)
‘HIV and work don't go together’: Employment as a social determinant of HIV outcomes among men who have sex with men and transgender women in the Dominican Republic
C. Barrington (2017)
Prevalence and correlates of anal intercourse among female sex workers in eSwatini
B. Owen (2020)
Sexual risk behaviour for transmission of HIV in men who have sex with men: recent findings and potential interventions
L. McDaid (2010)
Female sex workers in Africa: Epidemiology overview, data gaps, ways forward
E. Ngugi (2012)
23 Re-Emergence of HIV Infection and Syphilis Among Men Who Have Sex with Men
Maria Antonella Di Benedetto (2012)
Risk Factors Contributing to Transmission Rates of Chlamydia trachomatis and Neisseria gonorrhoeae Among Women in Veron, Dominican Republic
Camille Jeanette Henson (2011)
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