Brewer TH, Hasbun J, Ryan CA, et al. Migration, ethnicity and environment: HIV risk factors for women on the sugar cane plantations of the Dominican Republic. AIDS 12: 1879-1887

University of Connecticut, Storrs, Connecticut, United States
AIDS (Impact Factor: 5.55). 11/1998; 12(14):1879-87. DOI: 10.1097/00002030-199814000-00020
Source: PubMed


To determine risk factors for HIV infection among women living in the sugar cane plantation communities (bateyes) of a large private sugar cane company in the Dominican Republic.
Cross-sectional study of sexually active female volunteers living in the bateyes.
Of 98 bateyes, 23 were randomly selected and visited by a mobile medical unit, to interview, examine and test volunteers for seroreactivity to HIV and syphilis.
The 490 subjects ranged in age from 16 to 72 years (median, 37 years); 53% were born in Haiti, 36% in Dominican Republic bateyes, and 12% elsewhere in the Dominican Republic; 58% had no formal education; and 87% had no income. HIV seropositivity was found in 28 women (5.7%), including 8.8% of those aged < 35 years. By logistic regression analysis, HIV infection was independently associated with age < 35 years [odds ratio (OR), 4.5; P < 0.01), being single with children (OR, 4.3; P < 0.01), more than one lifetime sex partners (OR, 3.4; P = 0.06), engaging in sex during menses (OR, 3.2; P = 0.02), and self-description as a prostitute (OR, 4.4; P = 0.05)1. For Haitian women, those coming to the Dominican Republic alone were more likely to have HIV infection than those coming with a male partner. Less than 4% of women reported condom use at last intercourse.
Women in the bateyes have a much higher rate of HIV infection than that estimated for women in the general population of Dominican Republic and a rate comparable to that of female sex workers in the Dominican Republic. AIDS prevention in the bateyes should address condom education and distribution as well as employment opportunities and education for women.

Download full-text


Available from: Stephen E Hawes
  • Source
    • "Women end up depending heavily on their male partners for their own survival and that of their children. Although there has been an overwhelming amount of research around the world that testifies to the greater vulnerability of women than men to HIV/ AIDS (Anderson et al., 2002; Brewer et al., 1998; Giffin & Lowndes, 1999; Gupta & Selvaggio, 2007; ICRW, 2006; Mane & Aggleton, 2001; UNAIDS, 2002), only a few researchers have examined the stigma that relates to gender explicitly (Sandeowsky, Barroso, & Voils, 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Globally more women have been diagnosed with HIV/AIDS and are more likely to be stigmatized than men, especially in male-dominant societies. However, gender differences in the experience of HIV-related stigma have not been extensively explored. Researchers explore the gender differences in HIV/AIDS-related stigma experiences here. Interviews were conducted with eight HIV patients and their nine discordant family members in Ghana. Our findings include gender differences in disclosure and response to HIV/AIDS diagnosis. The negative impact of HIV-related stigma was found to be more extensive for women than men. Our findings may be used to facilitate an awareness and understanding through which supportive interventions can be implemented.
    Preview · Article · Feb 2014 · Health Care For Women International
  • Source
    • "First, truck drivers and other migrants (i.e. those who spend time living or traveling away from home) tend to have more sexual partners than the average in the population (Lurie et al, 2003a; Brewer et al, 1998; Brockerhoff and Biddlecom, 1999; Arnafi et al, 1997; Arnafi, 1993; Orubuloye, Caldwell and Caldwell, 1993). Second, the sexual partnerships these people have away from home tend to be higher risk than those they have at home, largely because their partners are more likely to be infected: for example, are more likely to be bar girls or commercial sex workers (Orubuloye et al, 1993). "
    [Show abstract] [Hide abstract]
    ABSTRACT: I generate new data on HIV incidence and prevalence in Africa based on inference from mortality rates. I use these data to relate economic activity (specifically, exports) to new HIV infections in Africa and argue there is a significant and large positive relationship between the two: a doubling of exports leads to as much as a quadrupling in new HIV infections. This relationship is consistent with a model of the epidemic in which truckers and other migrants have higher rates of risky behavior, and their numbers increase in periods with greater exports. I present evidence suggesting that the relationship between exports and HIV is causal and works, at least in part, through increased transit. The result has important policy implications, suggesting (for example) that there is significant value in prevention focused on these transit oriented groups. I apply this result to study the case of Uganda, and argue that a decline in exports in the early 1990s in that country appears to explain between 30% and 60% of the decline in HIV infections. This suggests that the success of the Ugandan anti-HIV education campaign, which encouraged changes in sexual behavior, has been overstated.
    Preview · Article · Dec 2007 · Journal of the European Economic Association
  • Source
    • "A caveat should precede what is primarily a study of perceptions and cultural ideas about HIV/AIDS. The severity of the epidemic in Gar! ıfuna communities is rooted squarely in the economic realities of labor migration, a significant factor in the epidemic globally (Brewer et al., 1998; Lurie et al., 2003; Lurie, Hintzen, & Lowe, 1995; Quinn, 1994). It is exacerbated by the need of young men to seek a living away from the community, who as economically peripheralized workers and members of an ethnic minority face increased risks for infection. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The HIV/AIDS epidemic along Honduras' north coast has intensified in recent years and become particularly severe in Garífuna communities. Based on a qualitative study in the community of Las Espinas and comparison with results from an earlier knowledge, attitudes, beliefs and practices survey, this article explores Garífuna ideas about the disease, focusing on issues of risk perception and stigma. Using correspondence analysis with data from systematic elicitation techniques we abstract the local schema of HIV/AIDS, showing how accurate knowledge of transmission co-occurs with cultural judgments about safe partners, increasing chances for infection. Despite broad familiarity with the disease in the community it remains highly stigmatized, suggesting continuing problems in coming to terms with the epidemic as treatment becomes more widely available in Honduras. Questions of power, sexuality and affective expectations about partners complicate the situation for women hoping to prevent infection. Given the broader risk environment characterized by labor migration and transnational movement, vital interventions and educational efforts in Garífuna communities will need to be complemented with prevention efforts in contexts where men make a living.
    Full-text · Article · Sep 2004 · Social Science & Medicine
Show more