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Amesty S, Perez-Figueroa R, Stonbraker S, Halpern M, Donastorg Y, Perez-Mencia M, Lantigua F, Soriano L, Baez-Caraballo P, Gilbert J, Buccini F, Sharp J, Hernandez B, Gelfond J, Cardwell E, Nicholas C, Egan KA, Gomes A, Van Dyke E, Nicholas SW, Grodman M, Taylor BS. High burden of sexually transmitted infections among under-resourced populations in the Dominican Republic. Ther Adv Infect Dis 2023; 10:20499361231193561. [PMID: 37663112 PMCID: PMC10472826 DOI: 10.1177/20499361231193561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background Sexually transmitted infections (STIs) are a major health issue, exacerbated by limited financial and infrastructural resources in developing countries. Methods Prevalence of STIs was assessed in two urban centers of the Dominican Republic (DR) among populations at high risk for STIs: pregnant youth, men who have sex with men (MSM), trans women (TG), batey residents, female sex workers, and people living with human immunodeficiency virus (HIV). We conducted a cross-sectional survey and biological specimen collection to screen for Chlamydia trachomatis, Neisseria gonorrhea, Mycoplasma genitalium, Trichomonas vaginalis (trichomoniasis), Treponema pallidum (syphilis), HIV, hepatitis B and C, and human papillomavirus (HPV) among at-risk populations between 2015 and 2018. Ureaplasma urealyticum testing was also conducted even though it is not considered a STI. A non-probability community sample was recruited. Descriptive statistics examined the prevalence of STIs by population. Results A total of 1991 subjects participated in the study. The median age was 26 years (range: 18-65). Most participants were female (65.3%), heterosexual (76.7%), and were not partnered (55.7%). Most of the participants reported unprotected vaginal sex in the last 6 months (54%); among MSM and TG almost half of the participants reported unprotected anal sex in the last 6 months and 17.6% reported drug use in the last 6 months. Almost half of the participants (49%) tested positive for one or more STIs. The most prevalent STI was Chlamydia trachomatis (12.8%), and human papillomavirus (11.9%). Among transgender women, 65.3% tested positive for an STI, 64.8% of female sex workers tested positive for an STI, and 53.8% of pregnant adolescents tested positive for an STI. Conclusion There is a high prevalence of STIs among key and under resourced populations in the DR. Our findings highlight the need to conduct further research to optimize prevention and care strategies for structurally vulnerable and under resourced populations in the DR.
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Affiliation(s)
- Silvia Amesty
- Department of Medical Humanities and Ethics, Center for Family and Community Medicine, Mailman School of Public Health, Columbia University Irving Medical Center, 10 Ft. Washington Avenue, PH, New York, NY 10032-8300, USA
| | - Rafael Perez-Figueroa
- Department of Urban-Global Health, Rutgers University School of Public Health, Piscataway, NJ, USA
| | - Samantha Stonbraker
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
| | - Mina Halpern
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Yeycy Donastorg
- Instituto Dermatológico de Cirugía y Piel Humberto Borgart, Santo Domingo, Dominican Republic
| | - Martha Perez-Mencia
- Instituto Dermatológico de Cirugía y Piel Humberto Borgart, Santo Domingo, Dominican Republic
| | - Flavia Lantigua
- Instituto Dermatológico de Cirugía y Piel Humberto Borgart, Santo Domingo, Dominican Republic
| | - Leidy Soriano
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | | | | | | | - James Sharp
- BioReference Laboratories, Elmwood Park, NJ, USA
| | - Brian Hernandez
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Jonathan Gelfond
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Ethan Cardwell
- Melbourne School of Global and Population Health, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Nicholas
- University of Rochester Medical Center, Golisano Children’s Hospital, Rochester, NY, USA
| | | | - Angelina Gomes
- Grossman School of Medicine, New York University, New York, NY, USA
| | | | | | - Marc Grodman
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Barbara S. Taylor
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
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Stonbraker S, Sanabria G, Cunto-Amesty S, Alcántara C, Abraído-Lanza AF, Rowell-Cunsolo T, Halpern M, Bakken S, Schnall R, George M. "If They Give Their Mind to HIV, They Don't Last as Long": An Explanatory Model of HIV Infection in a Limited-Resource Setting Informs Person-Centered Care. Glob Qual Nurs Res 2022; 9:23333936221097112. [PMID: 35719278 PMCID: PMC9203948 DOI: 10.1177/23333936221097112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/04/2022] [Accepted: 03/19/2022] [Indexed: 11/18/2022] Open
Abstract
Explanatory models describe individuals’ perceptions of their illness experiences, which can guide culturally relevant care. We constructed an explanatory model of the experience of living with human immunodeficiency virus (HIV) in the Dominican Republic. Following qualitative descriptive methodology, we conducted interviews in Spanish using a semi-structured interview guide developed using Kleinman’s explanatory model framework. Two bilingual researchers coded interview transcripts following conventional content analysis. We used deductive codes from Kleinman’s framework and inductive codes external to the framework to construct the codebook. We arranged codes by shared meaning into categories and constructed themes that reflected shared findings from inductive categories and deductive codes. Twenty-six persons living with HIV participated. They provided rich descriptions of their experiences represented by four cross-cutting themes, which informed the explanatory model. By incorporating this in-depth understanding of patients’ illness experiences into care delivery, nurses can cultivate culturally meaningful and trusting patient-centered partnerships that improve health.
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Affiliation(s)
- Samantha Stonbraker
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, USA
| | | | | | | | | | | | - Mina Halpern
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Suzanne Bakken
- Columbia University School of Nursing, New York, NY, USA
| | | | - Maureen George
- Columbia University School of Nursing, New York, NY, USA
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