Migration, ethnicity and environment: HIV risk factors for women on the sugar cane plantations of the Dominican Republic, reports a 5.7% of women (28 of 490) and 8.8% of women under the age of 35 tested positive for HIV. Comparatively, the national prevalence rate of HIV in the Dominican Republic is 1.0%. Similarly, Dominican Republic, A Guide for Global Health Workers, Medical Practitioners, and NGO Volunteers states that the prevalence of HIV is greater than 5% in the bateyes, consistent with the studies findings.
While working in the bateyes, I do not know if I treated any HIV-positive patients. We were not able to provide testing, local options for testing are expensive, and a stigma still exists around the disease. However, on the plane back to the States, I sat next to a perioperative nurse who was in the Dominican with a team of American surgeons, nurses, surgical technicians, and anesthesiologists to perform tubal ligations. The only cost to the patient was the cost for labs that the Dominican hospital required, including an HIV test. (This cost $40 which is still a huge barrier to those living in the bateyes.) The nurse shared that this year he had not had any HIV-positive cases but they also treated only a few Haitians. In previous years, they usually have 2-4 HIV-positive cases out of approximately 80 patients (2.5-5%) and almost all HIV-positive patients are Haitian.
There are many barriers to improving the situation: testing is difficult to obtain, treatment is expensive, stigma prevents patients from seeking treatment or telling their sexual partners, and little is done to prevent sexual transmission. Migration, ethnicity and environment: HIV risk factors for women on the sugar cane plantations of the Dominican Republic reported condom use in less than 4% of women interviewed (490) during last sexual intercourse. In some areas in the Dominican including the bateyes, condoms are culturally or religiously unaccepted. There is also little to no sexual education regarding the transmission of HIV or proper condom use.
Like many diseases, HIV is more prevalent in the bateyes than in the Dominican as a whole due largely to the lack of health education and access to medical care.
Sadler, Karen and Kim Wilson. “Dominican Republic: A Guide for Global Health Workers, Medical Practitioners, and NGO Volunteers.” Geisel Series in Global Health and Medicine. Dartmouth 2015.
Brewer, Toye H., et al. “Migration, ethnicity and environment: HIV risk factors for women on the sugar cane plantations of the Dominican Republic.” AIDS 1998, 12:1879-1887.
This project is supported by funding from a Middlebury College Community Engagement Cross Cultural Community Service Grant.