title: Taxonomy of Caribbean tourism alcohol venues: implications for HIV transmission.
abstract: BACKGROUND
  Tourism areas represent ecologies of heightened HIV vulnerability characterized by a disproportionate concentration of alcohol venues. Limited research has explored how alcohol venues facilitate HIV transmission.
  
  
  METHODS
  We spatially mapped locations of alcohol venues in a Dominican tourism town and conducted a venue-based survey of key informants (n=135) focused on three facets of alcohol venues: structural features, type of patrons, and HIV risk behaviors. Using latent class analysis, we identified evidence-based typologies of alcohol venues for each of the three facets. Focused contrasts identified the co-occurrence of classes of structural features, classes of types of patrons, and classes of HIV risk behavior, thus elaborating the nature of high risk venues.
  
  
  RESULTS
  We identified three categories of venue structural features, three for venue patrons, and five for HIV risk behaviors. Analysis revealed that alcohol venues with the greatest structural risks (e.g. sex work on-site with lack of HIV prevention services) were most likely frequented by the venue patron category characterized by high population-mixing between locals and foreign tourists, who were in turn most likely to engage in the riskiest behaviors.
  
  
  CONCLUSIONS
  Our results highlight the stratification of venue patrons into groups who engage in behaviors of varying risk in structural settings that vary in risk. The convergence of high-risk patron groups in alcohol venues with the greatest structural risk suggests these locations have potential for HIV transmission. Policymakers and prevention scientists can use these methods and data to target HIV prevention resources to identified priority areas.
authors.affiliation: Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003-6654 R321, United States. vincent.ramos@nyu.edu
authors.forename: Vincent
authors.initials: V
authors.lastname: Guilamo-Ramos
authors.forename: James
authors.initials: J
authors.lastname: Jaccard
authors.forename: Katharine
authors.initials: K
authors.lastname: McCarthy
authors.forename: Zahira
authors.initials: Z
authors.lastname: Quiñones
authors.forename: Viktor
authors.initials: V
authors.lastname: Lushin
authors.forename: Molly
authors.initials: M
authors.lastname: Skinner-Day
authors.forename: Mark
authors.initials: M
authors.lastname: Padilla
authors.forename: Leah
authors.initials: L
authors.lastname: Meisterlin
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000434:Alcoholic Beverages / Q000706:statistics & numerical data; D017691:Caribbean Region / Q000453:epidemiology; D016000:Cluster Analysis; D017280:Condoms; D003627:Data Interpretation, Statistical; D004293:Dominican Republic / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012309:Risk-Taking; D011477:Sex Work / Q000706:statistics & numerical data; D060386:Sex Workers / Q000706:statistics & numerical data; D014189:Transsexualism; D014195:Travel / Q000145:classification* / Q000706:statistics & numerical data
keywords: Alcohol venues; Dominican Republic; HIV transmission; Latent cluster analysis; Tourism