HIV Sexual Risk Behavior and Family Dynamics in a Dominican Tourism Town
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Expansion of the tourism industry in the Dominican Republic has had far-reaching health consequences for the local population. Research suggests families with one or more members living in tourism areas experience heightened vulnerability to HIV/STIs due to exposure to tourism environments, which can promote behaviors such as commercial and transactional sex and elevated alcohol use. Nevertheless, little is known about how tourism contexts influence family dynamics, which, in turn, shape HIV risk. This qualitative study examined family relationships through in-depth interviews with 32 adults residing in Sosúa, an internationally known destination for sex tourism. Interviewees situated HIV risk within a context of limited employment opportunities, high rates of migration, heavy alcohol use, and separation from family. This study has implications for effective design of health interventions that make use of the role of the family to prevent HIV transmission in tourism environments.
KeywordsDominican Republic Tourism Family Sexual risk behavior HIV/AIDS
Funding for this study was provided by the National Institute on Alcohol Abuse and Alcoholism (R21AA018078). We would like to express special thanks to Sarah Leavitt for her comments and feedback on the article.
- Anderson, R. M. (1996). The spread of HIV and sexual mixing patterns. In J. Mann & D. Tarantola (Eds.), AIDS in the world (pp. 457–514). New York: Oxford University Press.Google Scholar
- Asociación Nacional de Hoteles y Restaurantes Inc. (ANHRI). (2011). Estadísticas turísticas boletín abril de 2011. Retrieved from http://www.asonahores.com/index.php?option=com_content&task=view&id=23&Itemid=60.
- Barrington, C., Latkin, C., Sweat, M. D., Moreno, L., Ellen, J., & Kerrigan, D. (2009). Talking the talk, walking the walk: Social network norms, communication patterns, and condom use among the male partners of female sex workers in La Romana, Dominican Republic. Social Science and Medicine, 68, 2037–2044.PubMedCentralCrossRefPubMedGoogle Scholar
- Beard, J., Biemba, G., Brooks, M. I., Costello, J., Ommerborn, M., Bresnahan, M., et al. (2010). Children of female sex workers and drug users: A review of vulnerability, resilience and family-centered models of care. Journal of the International AIDS Society, 13(S2), S6-S13.Google Scholar
- Brennan, D. (1998). Everything is for sale here: Sex tourism in Sosúa, the Dominican Republic. New Haven, CT: Yale University.Google Scholar
- Brennan, D. (2003). When sex tourists and sex workers meet: Encounters within Sosúa, the Dominican Republic’s sexscape. In S. B. Gmelch (Ed.), Tourists and tourism (pp. 303–315). Prospect Heights, IL: Waveland Press.Google Scholar
- Cabezas, A. (2009). Economies of desire: Sex and tourism in the Dominican Republic and Cuba. Philadelphia, PA: Temple University Press.Google Scholar
- Caldwell, J. C., Anarfi, J. K., & Caldwell, P. (1997). Mobility, migration, sex, STDs and AIDS: An essay on Sub-Saharan Africa with other parallels. In G. Herdt (Ed.), Sexual cultures and migration in the era of AIDS: Anthropological and demographic perspectives (pp. 41–51). New York: Oxford University Press.Google Scholar
- Caribbean Tourism Organization (CTO). (2011). Latest statistics 2010. Barbados: Caribbean Tourism Organization. Retrieved from http://www.onecaribbean.org/statistics/2011statistics/default.aspx.
- Corbin, J. M., & Strauss, A. L. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks, CA: Sage.Google Scholar
- De Moya, E. A., Garcia, R., Fadul, R., & Herold, E. (1992). Report: Sosúa sanky-pankies and female sex workers: An exploratory study. Santo Domingo, Dominican Republic: La Universidad Autonoma de Santo Domingo.Google Scholar
- Des Jarlais, D. C. (2000). Structural interventions to reduce HIV transmission among injecting drug users. AIDS, 14(S14), S41-S46.Google Scholar
- Fereday, J., & Muir-Cochrane, E. (2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods, 5, 80–92.Google Scholar
- Forsythe, S., Hasbun, J., & Butler de Lister, M. (1998). Protecting paradise: Tourism and AIDS in the Dominican Republic. Health Policy and Planning, 13, 277-286.Google Scholar
- Guilamo-Ramos, V., Jaccard, J., Lushin, V., Martinez, R., Gonzalez, B., & McCarthy, K. (2011). HIV risk behavior among youth in the Dominican Republic: The role of alcohol and other drugs. Journal of the International Association of Physicians in AIDS Care, 10, 388–395.PubMedCentralCrossRefPubMedGoogle Scholar
- Guilamo-Ramos, V., Padilla, M., Meisterlin, L., McCarthy, K., & Lotz, K. (in press). Tourism ecologies, alcohol venues and HIV: Mapping spatial risk. International Journal of Hispanic Psychology.Google Scholar
- Gupta, G. R. (2002). Vulnerability and resilience: Gender and HIV/AIDS in Latin America and the Caribbean. Washington, DC: International Center for Research on Women.Google Scholar
- Hirsch, J. S., Wardlow, H., Smith, D. J., Phinney, H. M., Parikh, S., & Nathanson, C. A. (2010). The secret: Love, marriage, and HIV. Nashville, TN: Vanderbilt University Press.Google Scholar
- Kalichman, S. C. (2010). Social and structural HIV prevention in alcohol-serving establishments. Alcohol Research & Health, 33, 184–194.Google Scholar
- Kempadoo, K. (1999). Continuities and change: Five centuries of prostitution in the Caribbean. In K. Kempadoo (Ed.), Sun, sex and gold: Tourism and sex work in the Caribbean (pp. 3–33). New York: Rowman and Littlefield.Google Scholar
- Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
- Montgomery, A. (2011). Nightlife. Retrieved from http://www.monaga.net/website/en/nightlife.
- Morojele, N. K., Kachieng’a, M. A., Nkoko, M. A., Moshia, K. M., Mokoko, E., Parry, C. D. H., et al. (2004). Perceived effects of alcohol use on sexual encounters among adults in South Africa. African Journal of Drug and Alcohol Studies, 3, 1–20.Google Scholar
- Nepal, B. (2007). Population mobility and spread of HIV across the Indo-Nepal border.Journal of Health. Population and Nutrition, 25, 267–277.Google Scholar
- Parry, C. D. H. (2000). Alcohol problems in developing countries: Challenges for the new millennium. Suchtmed, 2, 216–220.Google Scholar
- Pina, D. (2007). Dominican Republic: Remittances for development. Inter Press Service. Retrieved from http://ipsnews.net/news.asp?idnews=39306.
- Prado, G., Pantin, H., Briones, E., Schwartz, S. J., Feaster, D., Huang, S., et al. (2007). A randomized controlled trial of a parent-centered intervention in preventing substance use and HIV risk behaviors in Hispanic adolescents. Journal of Consulting and Clinical Psychology, 75, 914–926.PubMedCentralCrossRefPubMedGoogle Scholar
- Richter, L. M. (2010). An introduction to family-centered services for children affected by HIV and AIDS. Journal of the International AIDS Society, 13(S2), S1–S6.Google Scholar
- Santo Domingo Direct. (2011). Santo Domingo direct. Retrieved from http://www.mariosessions.com/santodomingoclubs.htm.
- Schwartz, R. (1999). Pleasure island: Tourism and temptation in Cuba. Lincoln: University of Nebraska Press.Google Scholar
- Soletti, A., Guilamo-Ramos, V., Burnette, D., Sharma, S., Bouris, A. (2009). India-U.S. collaboration to prevent adolescent HIV-infection: The feasibility of a family-based HIV-prevention intervention for rural Indian youth. Journal of International AIDS Society, 12.Google Scholar
- UNAIDS. (2010). UNAIDS report on the global AIDS epidemic. Retrieved from http://www.unaids.org/globalreport/global_report.htm.
- United States Agency for International Development (USAID). (2008). A story to tell: Better health in Latin America and the Caribbean. Retrieved from http://www.usaid.gov/locations/latin_america_caribbean/pdf/USAID_Story_on_Health_in_LAC.pdf.
- United States Agency for International Development (USAID). (2010). Dominican Republic: HIV/AIDS health profile. Retrieved from http://www.usaid.gov/our_work/global_health/aids/Countries/lac/domreppub_profile.pdf.
- World Bank. (2006). Document of the World Bank, the Inter-American Bank and the Government of the Dominican Republic Report No. 32422-DO. Retrieved from http://irispublic.worldbank.org/85257559006C22E9/All+Documents/85257559006C22E9852572890074BCA1/$File/DominicanRepub0rtyAssessmentEnglish.pdf.
- World Health Organization (WHO). (2008). Global health atlas. Retrieved from http://apps.who.int/globalatlas/default.asp.
- World Travel and Tourism Council (WTTC). (2011). Travel and economic impact–Caribbean. London: WTTC.Google Scholar
- Yang, X., & Xia, G. (2009). Gender, migration, and unprotected causal and commercial sex: Individual and social determinants of HIV and STD risk among female migrants. In D. C. Poston, J. Tucker, Q. Ren, B. Gu, X. Zheng, S. Wong, & C. Russell (Eds.), Gender policy and HIV in China: The Springer series on demographic methods and population analysis (Vol. 22, pp. 97–114). New York: Springer.CrossRefGoogle Scholar