The HIV/AIDS Epidemic in the Dominican Republic: Key Contributing Factors.
The HIV/AIDS Epidemic in the Dominican Republic: Key Contributing Factors.
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DOI：
10.1177/1545109710397770
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发表时间：
2011-09
期刊：
影响因子：
--
通讯作者：
Rosenberg R
中科院分区：
文献类型：
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作者：
Rojas P;Malow R;Ruffin B;Rothe EM;Rosenberg R
本文回顾了多米尼加共和国的艾滋病毒/艾滋病流行病学数据和最近进行的研究，重点解释了该国估计血清发病率和流行率的变异性。艾滋病毒血清阳性率估计值从1.0%（一般人群）到11.0%（男男性行为者）不等。一些人指出，艾滋病毒血清阳性率最高的地方是海地称为bateyes的飞地（美国国际开发署[美援署]，2008年），这些飞地是主要为多米尼加共和国制糖业服务的移徙工人棚户区。其他人则报告称，在旅游业和性产业相关领域，bateyes的税率更高或相当。与其他加勒比和拉丁美洲国家一样，多米尼加共和国报告的艾滋病毒传播主要是由于无保护的异性性行为，妇女的感染率一直在急剧上升。多米尼加共和国占伊斯帕尼奥拉岛的三分之二;西三分之一被海地占领，海地是西半球艾滋病毒流行率最高的国家。虽然数据有限，但它显示了这两个国家之间血清阳性率和发病率的重要差异，但贫困，性别不平等和耻辱等共同点似乎是推动流行病的关键因素。本文将讨论这些和其他因素，可能有助于艾滋病毒在多米尼加共和国的流行，以及突出的文献中的差距，并提供建议，以指导在这一领域的进一步工作，特别是在可持续的艾滋病毒预防的作用治理。
This article reviews HIV/AIDS epidemiological data and recent research conducted in the Dominican Republic, with a focus on explaining the variability in estimated seroincidence and prevalence within the country. HIV seroprevalence estimates range from 1.0% (in the general population) to 11.0% among men who have sex with men (MSM). Some have indicated that the highest HIV seroprevalence occurs in Haitian enclaves called bateyes (US Agency for International Development [USAID], 2008), which are migrant worker shantytowns primarily serving the sugar industry in the Dominican Republic. Others report higher or comparable rates to the bateyes in areas related to the tourism and sex industries. As in other Caribbean and Latin American countries, reported HIV transmission in the Dominican Republic is predominantly due to unprotected heterosexual sex and the infection rate has been increasing disproportionally among women. The Dominican Republic represents two thirds of the Hispaniola island; the western one third is occupied by Haiti, the nation with the highest HIV prevalence in the western hemisphere. Although data is limited, it shows important differences in seroprevalence and incidence between these two countries, but commonalities such as poverty, gender inequalities, and stigma appear to be pivotal factors driving the epidemic. This article will discuss these and other factors that may contribute to the HIV epidemic in the Dominican Republic, as well as highlight the gaps in the literature and provide recommendations to guide further work in this area, particularly in the role of governance in sustainable HIV prevention.