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The Role of Citizenship Status in HIV Testing among Rural Communities of the Dominican Republic

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Objective: To evaluate the role of citizenship and sociodemographic status of batey residents in HIV-related behaviours and testing in rural Dominican Republic to gain a better understanding of access barriers to care that will inform public health measures aimed at HIV surveillance and eliminating transmission.

Methods: A cross-sectional survey about HIV testing history and perceptions regarding HIV infection was administered to 1197 batey inhabitants in 20 rural communities in the province of Monte Plata, Dominican Republic.

Results: Overall, 63% of respondents reported having had an HIV test performed: 67.6% of citizens and 44.8% of non-citizens. Non-citizens were 34% less likely to have had an HIV test performed than citizens (p < 0.0001). Overall, men were 31% less likely to have had an HIV test than women (RR: 0.69, 95% CI: 0.63, 0.76). Non-citizen men and women were 47% and 25% respectively, less likely to have had an HIV test compared to citizens (both men and women, p < 0.0001).

Conclusion: Citizenship is an important and overlooked determinant of health awareness. Non-citizens are less likely to know their HIV status, a key component in the propagation of the HIV pandemic. Considering that batey residents already comprise a vulnerable population and have limited access to health services, advancements in combating HIV would likely be achieved through domestic public health measures more inclusive of residents irrespective of legal status.

February 28, 2014
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