ABSTRACT

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.