70 The Global HIV Epidemics among Sex Workers
ments would be forced to relocate themselves to a specific area of a given city. This law has not been passed to date and was objected to by sex worker rights groups and non-governmental organizations working on HIV prevention in the country as it would potentially lead to greater levels of violence and stigma and discrimination towards sex workers (Pantaleon, 2011). Epidemiology of and Risks Factors for HIV Among Sex Workers According to the most recent surveillance conducted in the Dominican Republic in 2008 the overall prevalence of HIV among sex workers is 4.8 percent, ranging from 3.3 percent in Santo Domingo, where intensive intervention activities have been conducted over the past two decades, to 6.4 percent in regions with limited to no interventions. Prior government sponsored sentinel surveillance systems among female sex workers as well as other groups such as pregnant women and STI clinic patients are not currently active. Currently periodic, every few years, bio-behavioral surveillance coordinated by the Dominican government with support from the U.S. Centers for Disease Control and Prevention (CDC) is being conducted in the country among female sex workers (COPRESIDA, 2009). Limited quantitative research and HIV-related surveillance has been conducted with male or transgender sex workers in the DR. The one known HIV prevalence assessment conducted among “gigolos”, understood to be male sex workers, in the mid-1990s documented HIV prevalence at 6.5 percent among this population group (Tabet et al, 1996). No HIV surveillance efforts have ever specifically focused on the clients of sex workers in the DR.
HIV prevalence (percent)
Figure 3.3 Trends in HIV Prevalence among Female Sex Workers in Santo Domingo, 1991–2004
18 16 14 12 10 8 6 4 2 0
High Median Low
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Year
Source: Adapted from Halperin et al. 2009.
Analyses based on prior sentinel surveillance work conducted in Santo Domingo, where significant intervention work has taken place among female