RESUMO
While the Caribbean has the second highest global human immunodeficiency virus (HIV) prevalence, insufficient attention has been paid to contributing factors of the region's elevated risk. Largely neglected is the potential role of drugs in shaping the Caribbean HIV/acquired immune deficiency syndrome epidemic. Caribbean studies have almost exclusively focused on drug transportation and seldom acknowledged local user economies and drug-related health and social welfare consequences. While tourism is consistently implicated within the Caribbean HIV epidemic, less is known about the intersection of drugs and tourism. Tourism areas represent distinct ecologies of risk often characterised by sex work, alcohol consumption and population mixing between lower and higher risk groups. Limited understanding of availability and usage of drugs in countries such as the Dominican Republic (DR), the Caribbean country with the greatest tourist rates, presents barriers to HIV prevention. This study addresses this gap by conducting in-depth interviews with 30 drug users in Sosúa, a major sex tourism destination of the DR. A two-step qualitative data analysis process was utilised and interview transcripts were systematically coded using a well-defined thematic codebook. Results suggest three themes: (1) local demand shifts drug routes to tourism areas, (2) drugs shape local economies and (3) drug use facilitates HIV risk behaviours in tourism areas.
Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Viagem , Adulto , República Dominicana/epidemiologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Prevalência , Pesquisa Qualitativa , Fatores de Risco , Trabalho SexualRESUMO
Expansion of the tourism industry in the Dominican Republic has had far-reaching health consequences for the local population. Research suggests families with one or more members living in tourism areas experience heightened vulnerability to HIV/STIs due to exposure to tourism environments, which can promote behaviors such as commercial and transactional sex and elevated alcohol use. Nevertheless, little is known about how tourism contexts influence family dynamics, which, in turn, shape HIV risk. This qualitative study examined family relationships through in-depth interviews with 32 adults residing in Sosúa, an internationally known destination for sex tourism. Interviewees situated HIV risk within a context of limited employment opportunities, high rates of migration, heavy alcohol use, and separation from family. This study has implications for effective design of health interventions that make use of the role of the family to prevent HIV transmission in tourism environments.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Infecções por HIV/transmissão , Assunção de Riscos , Trabalho Sexual , Comportamento Sexual , Adulto , República Dominicana , Emprego , Relações Familiares , Feminino , Infecções por HIV/prevenção & controle , Humanos , Masculino , Trabalho Sexual/estatística & dados numéricos , Meio Social , Viagem , Sexo sem Proteção , Adulto JovemRESUMO
The present study examined cognitive and emotional correlates of sexual decision-making among three groups of Dominican adolescents: (a) Dominican youth who were born and raised in New York City, (b) Dominican youth who recently immigrated to New York City from the Dominican Republic, and (c) Dominican adolescents who were born and currently reside in the Dominican Republic. Data were collected via self-administered questionnaires from Dominican mother-adolescent dyads in New York City (n = 1,008) and the Dominican Republic (n = 213). Across groups, positive emotion constructs were consistently among the most important correlates of intentions to engage in sexual intercourse while issues related to STIs and HIV showed the lowest correlations. Interestingly, positive correlations with intentions to engage in intercourse were found among Dominican-residing males, as were positive correlations with intentions among Dominican-residing females. The implications for HIV prevention programs for Dominican youth are discussed.