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HIV/AIDS and the Dominican Republic: A look at a Pandemic
“HIV (human immunodeficiency virus) was identified in 1984 as the cause of AIDS. It selectively grows in particular white cells in the blood known as CD4+ T lymphocytes, which are essential to the body's immune response. It eventually damages or kills these cells, releasing further virus to continue the spread of the infection in the body.”

“AIDS (acquired immunodeficiency syndrome) is caused by HIV. By killing or damaging CD4 cells, HIV progressively destroys the body's ability to fight infections and certain cancers. People who are HIV positive are liable to infection with viruses, bacteria or yeasts which do not normally harm people, so-called opportunistic infections. As the number of CD4+ T-lymphocytes decreases, the risk and severity of opportunistic illnesses increases. A person has AIDS when they have one or more of the over twenty most common opportunistic infections that define AIDS, also called "AIDS-defining illness," or if their CD4 Cell count is below 200.”


In the Dominican Republic AIDS has become an issue of pressing concern. Though seropositive prevalence rates have remained stable at 2.5%, due to the successes of national prevention strategies, the possibility of rate increases are always present. The rate of HIV infection is about equal in males and females, though infection rates in young women are rapidly escalating, which is of great concern to pregnant women because they can pass the virus to their unborn child.

Stigmas associated with the disease, the lack of sufficient medical resources, and a lack of proper education have all become challenges in the overall HIV/AIDS objective. These challenges make living with HIV/AIDS, or preventing the spread of the disease, a difficult task. Even from a legal and human rights point of view the public debate about AIDS in the Dominican Republic is many years behind where it should be, because the topic is seen as a social taboo.

To overcome the many challenges posed by HIV/AIDS in the Dominican Republic, efforts at prevention have become focused on linking the public sector with the private sector, creating an efficient network of resources and approaches that can provide the best quality healthcare for patients. The public sector, represented by an already established medical network and infrastructure, and the private sector of the non-governmental organizations converge, consequently, increasing the availability of quality services. The prevention strategies are aimed at encouraging healthy behavior and increased personal responsibility among target groups, such as sex workers, men who have sex with men, adolescents, hotel employees, and workers on the bateyes, which are the small communities located near sugar cane fields that provide housing for workers.

Prevention efforts also include increased cooperation between the Dominican Republic and Haiti. Although the bateyes, rural slum towns mostly populated by first generation Haitian migrants, are a focus area, the mechanization of the sugar cane industry in the Dominican Republic has more and more Haitian laborers seeking work in alternative fields such as construction and commerce, turning Haiti’s higher rate of incidence into a grim reality and a domestic problem for the Dominican Republic. With HIV/AIDS estimates of the Haitian population that could be infected with the virus ranging from 5 to 8%, and an estimated 50,000 people a year dying of AIDS in Haiti, the relationship between the two nations is crucial in the fight against AIDS.

Looking at the statistics on HIV/AIDS in the Dominican Republic and the Caribbean can be overwhelming, but it could be said that there is a move towards curbing the rise of the pandemic in the region.

The main mode of transmission of HIV/AIDS in the Dominican Republic is through heterosexual sex. Roughly 1.7% of the Dominican population has been infected with the disease, which translates to an estimated 88,000 people infected in the country. Of the 88,000 infected with HIV/AIDS, 62,800 are adult men between the ages of 15 and 49, and according to USAID, of all HIV/AIDS cases reported, nearly three quarters are male.

The disease has greatly affected the female population, as it has become the leading cause of death among women of reproductive age. There are currently 23,000 adult women between the ages of 15 and 49 with HIV/AIDS. HIV/AIDS has also greatly affected children in the Dominican Republic. Estimates indicate that there are 2,200 children below the age of 15 infected by the disease, and that approximately 58,000 children were either orphans or at risk of becoming orphans because of HIV/AIDS.

Additionally, HIV/AIDS has become a regional concern. Almost half of all AIDS cases reported in the Dominican Republic are located in the country’s national district, followed by La Romana, Puerto Plata, Santiago, San Cristobal, Valverde and San Juan de la Maguana.

In addition, the Dominican Republic has disturbingly high tuberculosis rates (TB). This statistic is important because TB is closely related to HIV/AIDS, and is considered an opportunistic infection. TB infections have been reported at five times above the average for Latin America.

Though the Dominican Republic is the largest economy in the Caribbean, and is second in population and landmass, it spends only 5% percent of its GDP on total health care each year. This is 2.2% percent below the average rate for the rest of Latin America and the Caribbean.

To combat this there is an overwhelming presence of international aid organisations in the Dominican Republic, working alongside governmental organizations. These governmental and non-governmental organizations have actively responded to the disease, providing education on the topic, and preventing its spread.

COPRESIDA is the Presidential council on AIDS, and it works alongside the Dominican Republic’s Ministry of Health, SESPAS, which is an umbrella organization responsible for many HIV/AIDS projects. As well as SESPAS there is COIN, CEPROSH, and finally DIGETICSS, which is the National Program for the Control of STIs and AIDS.
 
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