title: Sexual behaviors and risk factors for HIV infection among men who have sex with men in the Dominican Republic.
abstract: OBJECTIVE
  To describe self-reported types of sexual identity of men who have sex with men (MSM) in the Dominican Republic, assess sociodemographics and behavioral characteristics, and measure the prevalence of HIV-1 and syphilis.
  
  
  METHODS
  Cross-sectional study of MSM recruited from a variety of community settings.
  
  
  METHODS
  A total of 354 men agreed to participate after giving verbal informed consent. Information was obtained using a standardized questionnaire assessing demographics and AIDS-relevant information. Blood was obtained for HIV and syphilis testing.
  
  
  RESULTS
  Five main sexual identity groups emerged: cross dressers, homosexuals, gigolos, bisexuals and heterosexuals. Receptive anal and oral intercourse were commonly reported by men self-identifying as cross dressers or homosexuals, whereas nearly all of the remaining three groups practiced only insertive intercourse. Sexual contact with women was also commonly reported; overall, consistent condom use was infrequent. HIV antibodies were detected in 11.0% and serologic evidence of syphilis was found in 7.3%. Factors independently associated with HIV infection included serologic evidence of syphilis, having visited at least one of four local brothels in 1975-1985, and having had receptive anal intercourse with four or more partners in the last 12 months.
  
  
  CONCLUSIONS
  Syphilis, sexual practices and social context of sex (commercial sex), rather than sexual identity per se, were associated with HIV infection. The complex social networks of MSM in this setting, the tendency to practice either insertive or receptive sex, but not both, infrequent condom use, high rates of syphilis and the frequency of sex with women need to be taken into account for targeted HIV prevention programs to be successful.
authors.affiliation: Department of Medicine, University of Washington, Seattle, 98122 USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Tabet
authors.forename: E A
authors.initials: EA
authors.lastname: de Moya
authors.forename: K K
authors.initials: KK
authors.lastname: Holmes
authors.forename: M R
authors.initials: MR
authors.lastname: Krone
authors.forename: M R
authors.initials: MR
authors.lastname: de Quinones
authors.forename: M B
authors.initials: MB
authors.lastname: de Lister
authors.forename: I
authors.initials: I
authors.lastname: Garris
authors.forename: M
authors.initials: M
authors.lastname: Thorman
authors.forename: C
authors.initials: C
authors.lastname: Castellanos
authors.forename: P D
authors.initials: PD
authors.lastname: Swenson
authors.forename: G A
authors.initials: GA
authors.lastname: Dallabeta
authors.forename: C A
authors.initials: CA
authors.lastname: Ryan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004293:Dominican Republic / Q000453:epidemiology; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology*; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012725:Sexual Behavior / Q000145:classification*; D013587:Syphilis / Q000453:epidemiology
chemical_list: D015483:HIV Antibodies