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Associations of HIV Testing, Sexual Risk and Access to Prevention Among Female Sex Workers in the Dominican Republic

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Abstract

The Caribbean region has one of the highest proportions of HIV in the general female population attributable to sex work. In 2008 (n = 1256) and 2012 (n = 1525) in the Dominican Republic, HIV biological and behavioral surveys were conducted among female sex workers (FSW) in four provinces using respondent driven sampling. Participants were ≥15 years who engaged in intercourse in exchange for money in the past 6 months and living/working in the study province. There were no statistically significant changes in HIV and other infections prevalence from 2008 to 2012, despite ongoing risky sexual practices. HIV testing and receiving results was low in all provinces. FSW in 2012 were more likely to receive HIV testing and results if they participated in HIV related information and education and had regular checkups at health centers. Further investigation is needed to understand barriers to HIV testing and access to prevention services.

Resumen

La Región del Caribe tiene uno de las más altas proporciones de VIH en la población general femenina que es atribuida al trabajo sexual. En 2008 (n = 1256) y en 2012 (n = 1525) en la Republica Dominicana, encuestas de vigilancia serológica y de comportamiento fueron realizadas entre trabajadoras sexuales femeninas (TSF) en cuatro provincias utilizando el método de muestreo dirigido por participantes. Mujeres ≥15 años que mantuvo relaciones sexuales a cambio de dinero en los últimos seis meses y viven/trabajan en una de las provincias del estudio fueron muestreadas. No hay cambios estadísticamente significativos en la prevalencia de VIH y otras infecciones desde 2008 a 2012, a pesar de las continuas prácticas sexuales de riesgo. La realización de la prueba de VIH y la recepción de los resultados fueron bajos en todas las provincias. Las TSF en 2012 fueron más propensas a realizarse la prueba de VIH y recibir los resultados si, en el año anterior recibieron información y educación relacionada con el VIH y se realizaron visitas regulares en los centros de salud. Es necesario investigar más a fondo para entender las barreras que impiden la realización de la prueba de VIH y el acceso a los servicios de prevención.

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Acknowledgements

The authors would like to thank the study participants and to acknowledge the involvement of Maritza Molina, Juan José Polanco, Sonia Báez, Adela Ramírez, Aurora Rodríguez, Nidia Ramón, Patricia León, Ángela de León, Mayra Toribio, Rosa Cruz, Ivelisse Sabagh, Henry Mercedes, Bayardo Gómez, Jaqueline Montero, Leonardo Sánchez, Santo Rosario, and Ceneyda Brito. In memory of Tony de Moya.

Funding

The study was funded by the President’s Emergency Plan for AIDS Relief (PEPFAR).

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the United States Centers for Disease Control and Prevention.

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Correspondence to Lisa G. Johnston.

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There are no conflict of interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study and the protocol was reviewed and approved by United States Centers for Disease Control and Prevention and the National AIDS Control Program of the Dominican Republic.

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Johnston, L.G., Bonilla, L., Caballero, T. et al. Associations of HIV Testing, Sexual Risk and Access to Prevention Among Female Sex Workers in the Dominican Republic. AIDS Behav 21, 2362–2371 (2017). https://doi.org/10.1007/s10461-016-1616-2

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