HIV and other infections among gay, transsexuals and men who have sex with men in the Dominican Republic
L. Johnston1, T. Caballero2, Y. Dolares3, H. Mercedes2
1University of California, San Francisco, Amsterdam, Netherlands, 2El Consejo Presidencial del SIDA, Santo Domingo, Dominican Republic, 3UNAIDS, Santo Domingo, Dominican Republic
Background: We describe HIV and other infections prevalence and behavioral correlates to HIV infection among gay, trans and men who have sex with men (GTM) in the Dominican Republic.
Methods: Respondent-driven sampling (RDS) was used to recruit men engaging in anal/oral sex with another man within the past six months, aged >15 years and living in one of the four study cities. Participants provided a blood sample for HIV, Hepatitis B (HBV), hepatitis C (HCV) and syphilis testing.
Results: From April-June 2008, 1387 GTM from Santo Domingo (n=510), Santiago (n=327), Barahona (n=280) and La Altagracia (n=270) were recruited into the survey. Most GTM in all cities self-identified as bisexual (39 to 63%) vs. MSM, gay, hetero or transsexual/transvestite. High percentages of GTM reported receiving payment for sex from a man in the past week (54% to 84.2%). HIV prevalence was >5% for all cities, HBV ranged from .6% (Barahona) to 3.5% (La Altagracia), HCV from .8% (Santo Domingo) to 6.9% (Barahona) and syphilis from 3.5% (La Altagracia) to 6.9% (Barahona). After controlling for city differences and number of past six month female sex partners, HIV positivity was associated with being older (≥ 30 years, AOR=8.1, CI. 2.9, 22.6), self-identified as Gay (AOR=3.9, CI. 1.2, 14.4) or Trans (AOR=9.1, CI. 2.7, 31.3), having ≥2 receptive anal sex partners in the past six months (AOR=2.2, CI. 1.1, 4.3), and testing positive for syphilis (AOR=3.2, CI. 1.5, 6.9) or HBV (AOR=3.3, CI. 1.1, 9.5).
Conclusions: GTM in the Dominican Republic, especially self-identified gays or transsexuals, have high rates of HIV and other infections. Targeted prevention interventions for these sub-populations are urgently needed and should include promotion of GTM friendly services incorporating important prevention messages on condom use, sexually transmitted infections and HIV testing, and linkages to appropriate care and treatment.
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