HIV testing, care, and treatment experiences among the steady male partners of female sex workers living with HIV in the Dominican Republic

AIDS Care. 2016;28(6):699-704. doi: 10.1080/09540121.2016.1160027. Epub 2016 Mar 24.

Abstract

Male steady partners of female sex workers (FSW) living with human immunodeficiency virus (HIV) represent a key population for treatment as prevention and/or pre-exposure prophylaxis interventions. This study uses data collected from male steady partners who were referred by FSW living with HIV participating in a multi-level HIV prevention and care intervention in Santo Domingo, Dominican Republic. We conducted a socio-behavioral survey and HIV testing with all men (n = 64) and 16 in-depth interviews with a sub-sample to obtain more depth. Thirty-five of the 64 participants were living with HIV; 27 were previously diagnosed and 8 were diagnosed during our study. As a result, 45% of men were members of sero-discordant sexual partnerships. Of men with no previous HIV diagnosis (n = 37), 15 had never been tested for HIV and nine had not been tested in the past two years. Ninety-three percent of men previously diagnosed with HIV reported receiving HIV care in the past 6 months and 78% were taking anti-retrovirals. Low HIV testing was partly due to men not feeling at risk for HIV, despite having an HIV-infected partner. Additionally, a lack of tailored care inhibited engagement in anti-retroviral treatment for those infected. HIV testing was low, highlighting a need for test-and-treat strategies. Men not living with HIV would benefit from regular testing and would be good candidates for pre-exposure prophylaxis. While almost all men who had been diagnosed with HIV were engaged in care and adherent to anti-retroviral therapy, future research should assess whether they are achieving optimal HIV outcomes for their health and prevention of ongoing transmission.

Keywords: AIDS; HIV-positive; Non-commercial partners; anti-retroviral treatment; pre-exposure prophylaxis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Anti-Retroviral Agents / therapeutic use*
  • Dominican Republic
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / drug therapy*
  • HIV Infections / prevention & control
  • HIV Infections / psychology
  • Humans
  • Interviews as Topic
  • Male
  • Medication Adherence
  • Middle Aged
  • Pre-Exposure Prophylaxis
  • Qualitative Research
  • Risk Factors
  • Risk-Taking
  • Sex Work
  • Sex Workers*
  • Sexual Partners*
  • Surveys and Questionnaires
  • Viral Load

Substances

  • Anti-Retroviral Agents