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Alcohol Use and HIV Risk Within Social Networks of MSM Sex Workers in the Dominican Republic

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Abstract

To examine how alcohol-related HIV risk behaviors within MSM sex workers’ social networks (SN) may be associated with individual risk behaviors, respondent-driven and venue-based sampling were used to collect demographic, behavioral and SN characteristics among MSM sex workers in Santo Domingo and Boca Chica (N = 220). The majority of participants reported problem drinking (71.0%) or alcohol use at their last sexual encounter (71.4%). Self-reported problem drinking was associated with SN characteristics (at least one member who recently got drunk aOR = 7.5, no religious/spiritual adviser aOR = 3.0, non-sexual network density aOR = 0.9), while self-reported alcohol use at last sex was associated with individual (drug use at last sex aOR = 4.4) and SN characteristics (at least one member with previous HIV/STI testing aOR = 4.7). Dominican MSM sex workers reported high alcohol use, which may increase their risk for HIV. A better understanding of SN factors associated with individual risk behaviors can help guide appropriate intervention development.

Resumen

Para examinar que comportamientos de riesgo asociados al VIH que involucren alcohol entre trabajadores sexuales HSH podrían estar asociados con comportamientos de riesgo individuales, muestreo impulsado por el encuestado y tuvo lugar en las zonas sexuales fueron utilizadas para recopilar características demográficas, conductuales, y de los redes sociales (RRSS) entre trabajadores sexuales HSH en Santo Domingo y Boca Chica (N = 220). La mayoría de los participantes reportaron tener problemas con el alcohol (71.0%) o usaron el alcohol dos horas antes o durante de su último encuentro sexual (71.4%). El problema con el alcohol autoreportado fue asociado con unas características de RRSS (al menos un miembro que se embriagó recientemente aOR = 7.5, ningún consejero religioso/spiritual aOR = 3.0, densidad de red no sexual aOR = 0.9), mientras que el consumo del alcohol en el último encuentro sexual autoreportado fue asociado con una características individuales (el uso de drogas en el último encuentro sexual aOR = 4.4) y de RRSS (al menos un miembro con prueba de VIH/ITS previa aOR = 4.7). Los trabajadores sexuales HSH dominicanos reportaron un consumo de alcohol alto, lo cual puede aumentar el riesgo de contraer VIH. Una mejor comprensión de los factores de RRSS asociados con comportamientos de riesgo individual podrían guiar el desarrollo de intervenciones apropiadas.

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References

  1. Centro de Estudios Sociales y Demográficos (CESDEM). Encuesta demográfica y de salud (ENDESA) 2002. http://www.cesdem.com/html/endesa_2002.pdf.

  2. Centro de Estudios Sociales y Demográficos (CESDEM). Encuesta demográfica y de salud republica dominicana (ENDESA) 2013. http://countryoffice.unfpa.org/dominicanrepublic/drive/DRDHS2013-Final02-10-2013.pdf.

  3. Equipo Nacional de la EVCVC. Segunda Encuesta de Vigilancia de Comportamiento con Vinculación Serológica en Poblaciones Claves 2012. http://www.mcr-comisca.org/sites/all/modules/ckeditor/ckfinder/userfiles/files/ECVC Republica Dominicana 2012.pdf.

  4. JV Toro-Alfonso. Proyecto Delta: identificacion y descripcion de conocimiento, actitudes, creencias, y comportamientos de riesgo para la transmision del VIH en poblacion de homosexuales y hombre que tienen sexo con hombres en la Republica Dominicana. Informe Final: Proyecto CONECTA-USAID; 2005.

  5. UNAIDS. Informe Nacional Sobre Los Avances En La Respuesta al Sida: Seguimiento a La Declaración Política De Las Naciones Unidas Sobre El Vih y El Sida, 2011 2014. http://www.unaids.org/sites/default/files/country/documents//dom_narrative_report_2014.pdf.

  6. El Programa Conjunto de la Naciones Unidas sobre el VIH/SIDA (ONUSIDA). Modelo de modos de transmision del VIH 2010. http://files.unaids.org/en/media/unaids/contentassets/documents/countryreport/2010/201011_MOT_DominicanRepublic_es.pdf.

  7. Padilla MB, Guilamo-Ramos V, Bouris A, Reyes AM. HIV/AIDS and tourism in the Caribbean: an ecological systems perspective. Am J Public Health. 2010;100(1):70–7.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Padilla MB, Guilamo-Ramos V, Godbole R. A syndemic analysis of alcohol use and sexual risk behavior among tourism employees in Sosúa, Dominican Republic. Qual Health Res. 2012;22(1):89–102.

    Article  PubMed  Google Scholar 

  9. Padilla M. Caribbean pleasure industry: tourism, sexuality, and AIDS in the Dominican Republic. Chicago, IL: University of Chicago Press; 2008.

    Google Scholar 

  10. World Health Organization. Noncommunicable Diseases (NCD) Country Profiles, 2014—Dominican Republic 2014. http://www.who.int/nmh/countries/dom_en.pdf.

  11. Brennan D. What’s love got to do with it?: Transnational desires and sex tourism in the Dominican Republic. Durham, North Carolina: Duke University Press; 2004.

    Book  Google Scholar 

  12. Pearlin LI, Radabaugh CW. Economic strains and the coping function of alcohol. AJS. 1976;82(3):652–63.

    CAS  PubMed  Google Scholar 

  13. Mossakowski KN. Is the duration of poverty and unemployment a risk factor for heavy drinking? Soc Sci Med. 2008;67(6):947–55.

    Article  PubMed  Google Scholar 

  14. Pachankis JE, Hatzenbuehler ML, Starks TJ. The influence of structural stigma and rejection sensitivity on young sexual minority men’s daily tobacco and alcohol use. Soc Sci Med. 2014;103:67–75.

    Article  PubMed  Google Scholar 

  15. Baral SD, Friedman MR, Geibel S, Rebe K, Bozhinov B, Diouf D, et al. Male sex workers: practices, contexts, and vulnerabilities for HIV acquisition and transmission. Lancet. 2015;385(9964):260–73.

    Article  PubMed  Google Scholar 

  16. Room R. Stigma, social inequality and alcohol and drug use. Drug Alcohol Rev. 2005;24(2):143–55.

    Article  PubMed  Google Scholar 

  17. Vosburgh HW, Mansergh G, Sullivan PS, Purcell DW. A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS Behav. 2012;16(6):1394–410.

    Article  PubMed  Google Scholar 

  18. Woolf SE, Maisto SA. Alcohol use and risk of HIV infection among men who have sex with men. AIDS Behav. 2009;13(4):757–82.

    Article  PubMed  Google Scholar 

  19. Vanable PA, McKirnan DJ, Buchbinder SP, Bartholow BN, Douglas JM Jr, Judson FN, et al. Alcohol use and high-risk sexual behavior among men who have sex with men: the effects of consumption level and partner type. Health Psychol. 2004;23(5):525–32.

    Article  PubMed  Google Scholar 

  20. Geibel S, Luchters S, King’ola N, Esu-Williams E, Rinyiru A, Tun W. Factors associated with self-reported unprotected anal sex among male sex workers in Mombasa, Kenya. J Sex Transm Dis. 2008;35(8):746–52.

    Article  Google Scholar 

  21. Luchters S, Geibel S, Syengo M, Lango D, King’ola N, Temmerman M, et al. Use of AUDIT, and measures of drinking frequency and patterns to detect associations between alcohol and sexual behaviour in male sex workers in Kenya. BMC Public Health. 2011;11(1):384.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Biello KB, Colby D, Closson E, Mimiaga MJ. The syndemic condition of psychosocial problems and HIV risk among male sex workers in Ho Chi Minh City, Vietnam. AIDS Behav. 2014;18(7):1264–71.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Okal J, Luchters S, Geibel S, Chersich MF, Lango D, Temmerman M. Social context, sexual risk perceptions and stigma: HIV vulnerability among male sex workers in Mombasa, Kenya. Cult Health Sex. 2009;11(8):811–26.

    Article  PubMed  Google Scholar 

  24. Rojas P, Malow R, Ruffin B, Roth E, Rosenberg R. The HIV/AIDS Epidemic in the Dominican Republic: Key Contributing Factors. JIAPAC. 2011.

  25. Sudhinaraset M, Wigglesworth C, Takeuchi DT. Social and cultural contexts of alcohol use: influences in a social-ecological framework. Alcohol Res. 2016;38(1):35–45.

    PubMed  PubMed Central  Google Scholar 

  26. Rosenquist JN, Murabito J, Fowler JH, Christakis NA. The spread of alcohol consumption behavior in a large social network. Ann Intern Med. 2010;152(7):426.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Single E, Wortley S. Drinking in various settings as it relates to demographic variables and level of consumption: findings from a national survey in Canada. J Stud Alcohol Drugs. 1993;54(5):590–9.

    Article  CAS  Google Scholar 

  28. Stall R, Paul JP, Greenwood G, Pollack LM, Bein E, Crosby GM, et al. Alcohol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men’s Health Study. Addiction. 2001;96(11):1589–601.

    Article  CAS  PubMed  Google Scholar 

  29. Berkman LF, Glass T. Social integration, social networks, social support and health. In: Berkman LF, Kawachi I, editors. Social epidemology. New York, NY: Oxford University Press, Inc.; 2000.

    Google Scholar 

  30. Fillmore KM. Drinking and problem drinking in early adulthood and middle age: An exploratory 20-year follow-up study. Quarterly journal of studies on alcohol. 1974.

  31. McCabe SE, Hughes TL, Bostwick WB, West BT, Boyd CJ. Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction. 2009;104(8):1333–45.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Reisner SL, Mimiaga MJ, Bland S, Skeer M, Cranston K, Isenberg D, et al. Problematic alcohol use and HIV risk among Black men who have sex with men in Massachusetts. Aids Care. 2010;22(5):577–87.

    Article  PubMed  Google Scholar 

  33. Bachman JG, Wadsworth KN, O’Malley PM, Johnston LD, Schulenberg JE. Smoking, drinking, and drug use in young adulthood: the impacts of new freedoms and new responsibilities. New York: Psychology Press; 2013.

    Google Scholar 

  34. O Malley PM. PM. Maturing out of problematic alcohol use. Alcohol Res Health. 2004;28(4):202.

    Google Scholar 

  35. Jones-Webb R, Smolenski D, Brady S, Wilkerson M, Rosser BS. Drinking settings, alcohol consumption, and sexual risk behavior among gay men. Addict Behav. 2013;38(3):1824–30.

    Article  PubMed  Google Scholar 

  36. Hirshfield S, Remien RH, Humberstone M, Walavalkar I, Chiasson MA. Substance use and high-risk sex among men who have sex with men: a national online study in the USA. AIDS Care. 2004;16(8):1036–47.

    Article  CAS  PubMed  Google Scholar 

  37. Mustanski B, Garofalo R, Herrick A, Donenberg G. Psychosocial health problems increase risk for HIV among urban young men who have sex with men: preliminary evidence of a syndemic in need of attention. Ann Behav Med. 2007;34(1):37.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Kerrigan D, Moreno L, Rosario S, Gomez B, Jerez H, Barrington C, et al. Environmental-structural interventions to reduce HIV/STI risk among female sex workers in the Dominican Republic. Am J Public Health. 2006;96(1):120–5.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Kerrigan D, Ellen JM, Moreno L, Rosario S, Katz J, Celentano DD, et al. Environmental-structural factors significantly associated with consistent condom use among female sex workers in the Dominican Republic. AIDS. 2003;17(3):415–23.

    Article  PubMed  Google Scholar 

  40. Murray L, Moreno L, Rosario S, Ellen J, Sweat M, Kerrigan D. The role of relationship intimacy in consistent condom use among female sex workers and their regular paying partners in the Dominican Republic. AIDS Behav. 2007;11(3):463–70.

    Article  PubMed  Google Scholar 

  41. Barrington C, Latkin C, Sweat MD, Moreno L, Ellen J, Kerrigan D. 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. Soc Sci Med. 2009;68(11):2037–44.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Gupta S, Murphy G, Koenig E, Adon C, Beyrer C, Celentano D, et al. Comparison of methods to detect recent HIV type 1 infection in cross-sectionally collected specimens from a cohort of female sex workers in the Dominican Republic. AIDS Res Hum Retrovir. 2007;23(12):1475–80.

    Article  CAS  PubMed  Google Scholar 

  43. Muhib FB, Lin LS, Stueve A, Miller RL, Ford WL, Johnson WD, et al. A venue-based method for sampling hard-to-reach populations. Public Health Rep. 2001;116(Suppl 1):216–22.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Magnani R, Sabin K, Saidel T, Heckathorn D. Review of sampling hard-to-reach and hidden populations for HIV surveillance. AIDS. 2005;19:S67–72.

    Article  PubMed  Google Scholar 

  45. Malekinejad M, Johnston LG, Kendall C, Kerr LRFS, Rifkin MR, Rutherford GW. Using respondent-driven sampling methodology for HIV Biological and behavioral surveillance in international settings: a systematic review. AIDS Behav. 2008;12(1):105–30.

    Article  Google Scholar 

  46. World Health Organization. Global status report on alcohol 2004. http://www.who.int/substance_abuse/publications/en/dominican_republic.pdf.

  47. Cooper DB. What is a ‘standard drink’? ICAP Report 5. J Subst Use. 1999;4(2):67–9.

    Article  Google Scholar 

  48. Ware JE, Keller SD, Kosinski M. SF-12: How to score the SF-12 physical and mental health summary scales: Health Institute, New England Medical Center; 1998.

  49. Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. J Clin Epidemiol. 1998;51(11):1171–8.

    Article  CAS  PubMed  Google Scholar 

  50. Reagans R, McEvily B. Network structure and knowledge transfer: the effects of cohesion and range. Adm Sci Q. 2003;48(2):240–67.

    Article  Google Scholar 

  51. Friedkin NE. Social Cohesion. Ann Rev Sociol. 2004;30(1):409–25.

    Article  Google Scholar 

  52. White DR, Harary F. The Cohesiveness of Blocks In Social Networks: node Connectivity and Conditional Density. Sociol Methodol. 2001;31(1):305–59.

    Article  Google Scholar 

  53. Adler NE, Boyce T, Chesney MA, Cohen S, Folkman S, Kahn RL, et al. Socioeconomic status and health: the challenge of the gradient. Am Psychol. 1994;49(1):15–24.

    Article  CAS  PubMed  Google Scholar 

  54. Casswell S, Pledger M, Hooper R. Socioeconomic status and drinking patterns in young adults. Addiction. 2003;98(5):601–10.

    Article  PubMed  Google Scholar 

  55. Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Ser B Stat Methodol. 1995;57(1):289–300.

    Google Scholar 

  56. Grant M, Litvak J. Drinking patterns and their consequences. Philadelphia, PA: Taylor & Francis; 1998.

    Google Scholar 

  57. Bullers S, Cooper ML, Russell M. Social network drinking and adult alcohol involvement: a longitudinal exploration of the direction of influence. Addict Behav. 2001;26(2):181–99.

    Article  CAS  PubMed  Google Scholar 

  58. Central Intelligence Agency. The world factbook: field listing: religions. https://www.cia.gov/library/publications/the-world-factbook/fields/2122.html.

  59. Vibe. Religious Anti-LGBT Group Takes Over The Streets Of The Dominican Republic 2016. Updated June 15, 2016. http://www.vibe.com/2016/06/anti-lgbt-group-protests-dominican-republic/.

  60. Fox News Latino. Vatican replaces Dominican archbishop who clashed with gay U.S. ambassador 2016. Updated July 5, 2016. http://latino.foxnews.com/latino/news/2016/07/05/vatican-replaces-dominican-archbishop-who-clashed-with-us-gay-ambassador/print.

  61. Felmlee DH. Interaction in social networks. In: Delamater J, editor. Handbook of social psychology. Boston, MA: Springer; 2006. p. 389–409.

    Chapter  Google Scholar 

  62. Statistics Solutions. Two-Stage Least Squares (2SLS) Regression Analysis 2016 .http://www.statisticssolutions.com/two-stage-least-squares-2sls-regression-analysis/.

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Acknowledgements

Dr. Ian Holloway is the Principal Investigator (PI) of this study. As PI, Dr. Holloway oversaw and provided guidance on all aspects of this paper. Diane Tan served as the study coordinator and oversaw data collection and management and conducted all analyses described in this paper. She was the primary contributor to the Methods, Discussion and Conclusions sections of this paper. Jennifer Gildner provided statistical support and Juan C. Jauregui was the primary contributor to the overall literature review and Introduction section of this paper. Drs. Rafael Garcia Alvarez and Vincent Guilamo-Ramos provided their expertise on this topic and guidance on the conceptual framework for this study.

Disclosure

Disclosure of potential conflicts of interest: Dr. Ian Holloway received funding for this study through the UCLA Center for AIDS Research (CFAR) and Center for HIV Identification, Prevention and Treatment (CHIPTS). All other authors do not have any conflicts of interest to declare.

Funding

This work was supported by the UCLA Center for AIDS Research (CFAR) grant [AI028697] and the Center for HIV Identification, Prevention, and Treatment (CHIPTS) NIMH grant [MH58107]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Department of Health Policy and Management, UCLA Fielding School of Public Health, 337 Charles Young Drive, Room 5243, Los Angeles, CA, USA

    Diane Tan

  2. Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA

    Ian W. Holloway

  3. UCLA Center for HIV Identification, Prevention and Treatment Services, Los Angeles, CA, USA

    Jennifer Gildner

  4. College of Letters and Science, University of California, Los Angeles, CA, USA

    Juan C. Jauregui

  5. Instituto de Sexualidad Humana, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic

    Rafael Garcia Alvarez

  6. Center for Latino Adolescent and Family Health (CLAFH), New York University, New York, NY, USA

    Vincent Guilamo-Ramos

  7. Sosua, Dominican Republic

    Vincent Guilamo-Ramos

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  1. Diane Tan
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  6. Vincent Guilamo-Ramos
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Correspondence to Diane Tan.

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Dr. Ian Holloway received support through the UCLA Center for AIDS Research (CFAR) and Center for HIV Identification, Prevention and Treatment (CHIPTS). All other authors do not have any conflicts of interest to declare.

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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.

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Informed consent was obtained from all individual participants included in the study.

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Tan, D., Holloway, I.W., Gildner, J. et al. Alcohol Use and HIV Risk Within Social Networks of MSM Sex Workers in the Dominican Republic. AIDS Behav 21 (Suppl 2), 216–227 (2017). https://doi.org/10.1007/s10461-017-1896-1

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