title: HIV testing, care, and treatment experiences among the steady male partners of female sex workers living with HIV in the Dominican Republic.
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.
authors.affiliation: a Division of Global Public Health , University of California , San Diego , CA , USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Fleming
authors.affiliation: b Department of Health Behavior , University of North Carolina , Chapel Hill , NC , USA.
authors.forename: Clare
authors.initials: C
authors.lastname: Barrington
authors.affiliation: c HIV Vaccine Trials Unit , Instituto Dermatológico y Cirugía de Piel 'Dr. Huberto Bogaert Díaz' , Santo Domingo , Dominican Republic.
authors.forename: Martha
authors.initials: M
authors.lastname: Perez
authors.affiliation: c HIV Vaccine Trials Unit , Instituto Dermatológico y Cirugía de Piel 'Dr. Huberto Bogaert Díaz' , Santo Domingo , Dominican Republic.
authors.forename: Yeycy
authors.initials: Y
authors.lastname: Donastorg
authors.affiliation: d Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Deanna
authors.initials: D
authors.lastname: Kerrigan
mesh_terms: D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D004293:Dominican Republic; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D065129:Pre-Exposure Prophylaxis; D036301:Qualitative Research; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work; D060386:Sex Workers; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents
keywords: AIDS; HIV-positive; Non-commercial partners; anti-retroviral treatment; pre-exposure prophylaxis