title: HIV/AIDS and tourism in the Caribbean: an ecological systems perspective.
abstract: The Caribbean has the highest HIV rates outside of sub-Saharan Africa. In recent decades, tourism has become the most important Caribbean industry. Studies suggest that tourism areas are epicenters of demographic and social changes linked to HIV risk, such as transactional sex, elevated alcohol and substance use, and internal migration. Despite this, no formative HIV-prevention studies have examined tourism areas as ecologies that heighten HIV vulnerability. HIV/AIDS research needs to place emphasis on the ecological context of sexual vulnerability in tourism areas and develop multilevel interventions that are sensitive to this context. From our review and integration of a broad literature across the social and health sciences, we argue for an ecological approach to sexual health in Caribbean tourism areas, point to gaps in knowledge, and provide direction for future research.
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 109 Observatory St, Room 3830, Ann Arbor, MI 48108, USA. padillam@umich.edu
authors.forename: Mark B
authors.initials: MB
authors.lastname: Padilla
authors.forename: Vincent
authors.initials: V
authors.lastname: Guilamo-Ramos
authors.forename: Alida
authors.initials: A
authors.lastname: Bouris
authors.forename: Armando Matiz
authors.initials: AM
authors.lastname: Reyes
mesh_terms: D017691:Caribbean Region / Q000453:epidemiology; D004641:Emigration and Immigration; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D008297:Male; D009790:Occupations / Q000706:statistics & numerical data; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work; D012725:Sexual Behavior; D012931:Social Environment; D019966:Substance-Related Disorders / Q000150:complications; D014195:Travel / Q000191:economics