{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:57:30Z","timestamp":1740135450060,"version":"3.37.3"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T00:00:00Z","timestamp":1581033600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T00:00:00Z","timestamp":1581033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>The Dominican Republic (DR) ranks among nations with the highest burden of HIV in the Caribbean. Cultural and gender roles in rural areas of the DR may place women at increased HIV risk. However, little is known about sexual health and HIV testing behaviors among women in the rural DR.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a needs assessment among a systematic sample of adult women in a rural DR community in 2016. Demographic and behavioral attributes related to HIV testing, sexual health, and healthcare utilization were evaluated. Poisson regression analysis was used to identify demographics and behaviors associated with having had a previous HIV test. Significance was defined as a <jats:italic>p<\/jats:italic>-value &lt;\u20090.05.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Among 105 women evaluated, 77% knew someone with HIV and 73% of women reported that they would be very or extremely likely to take an HIV test if offered. Only 68% reported a previous HIV test, including 47% who were tested over 2 years prior. Barriers to HIV testing included low risk perception (23%), distance or requisite travel (13%), and discomfort being tested (11%). Women who had never been tested for HIV were more likely than those who had been tested to be older (<jats:italic>p<\/jats:italic>\u00a0=\u20090.03), to have a lower level of education (<jats:italic>p<\/jats:italic>\u00a0=\u20090.04), and to have never been tested for other sexually transmitted infections (STI; <jats:italic>p<\/jats:italic>\u00a0&lt;\u2009\u00a00.01). In the Poisson multiple regression model, the only significant predictor of having had an HIV test was having had an STI test (<jats:italic>p<\/jats:italic>\u00a0=\u20090.03).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In the rural DR, numerous barriers contribute to low prevalence of HIV testing among women. Most women report willingness to have an HIV test and many engage in routine health care, indicating that this population may benefit from incorporating HIV testing and other sexual health promotion activities into routine medical care.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12905-020-0891-2","type":"journal-article","created":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T00:06:10Z","timestamp":1581033970000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A cross-sectional evaluation of HIV testing practices among women in the rural Dominican Republic"],"prefix":"10.1186","volume":"20","author":[{"given":"Madeline C.","family":"Montgomery","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Alholm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexi","family":"Almonte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin J.","family":"Sykes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Rudolph","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Cusick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Castello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genoviva","family":"Sowemimo-Coker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Haberlack","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0964-5895","authenticated-orcid":false,"given":"Philip A.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,7]]},"reference":[{"key":"891_CR1","volume-title":"Global AIDS update 2016","author":"UNAIDS","year":"2016","unstructured":"UNAIDS. Global AIDS update 2016. Geneva: Joint United Nations Programme on HIV\/AIDS; 2016."},{"issue":"3","key":"891_CR2","doi-asserted-by":"publisher","first-page":"423","DOI":"10.3325\/cmj.2008.3.423","volume":"49","author":"AS Muula","year":"2008","unstructured":"Muula AS. HIV infection and AIDS among young women in South Africa. Croat Med J. 2008;49(3):423\u201335.","journal-title":"Croat Med J"},{"issue":"1","key":"891_CR3","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/S0020-7292(97)02864-6","volume":"58","author":"S Koetsawang","year":"1997","unstructured":"Koetsawang S, Auamkul N. HIV and women in Thailand: severity and services. Int J Gynecol Obstet. 1997;58(1):121\u20137.","journal-title":"Int J Gynecol Obstet"},{"issue":"5","key":"891_CR4","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1177\/1545109710397770","volume":"10","author":"P Rojas","year":"2011","unstructured":"Rojas P, Malow R, Ruffin B, Rothe EM, Rosenberg R. The HIV\/AIDS Epidemic in the Dominican Republic: Key Contributing Factors. J Int Assoc Physicians AIDS Care Chic Ill 2002. 2011;10(5):306\u201315.","journal-title":"J Int Assoc Physicians AIDS Care Chic Ill 2002"},{"key":"891_CR5","volume-title":"Global report: UNAIDS report on the global AIDS epidemic 2013","author":"UNAIDS","year":"2013","unstructured":"UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2013. Geneva: Joint United Nations Programme on HIV\/AIDS; 2013."},{"issue":"Supplement 1","key":"891_CR6","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.1097\/QAI.0b013e3181a267e4","volume":"51","author":"DT Halperin","year":"2009","unstructured":"Halperin DT, de Moya EA, P\u00e9rez-Then E, Pappas G, Garcia Calleja JM. Understanding the HIV Epidemic in the Dominican Republic: A Prevention Success Story in the Caribbean? J Acquir Immune Defic Syndr. 2009;51(Supplement 1):S52\u20139.","journal-title":"J Acquir Immune Defic Syndr"},{"key":"891_CR7","volume-title":"2006 report on the global AIDS epidemic","author":"UNAIDS","year":"2006","unstructured":"UNAIDS. 2006 report on the global AIDS epidemic. Geneva: Joint United Nations Programme on HIV\/AIDS; 2006."},{"issue":"8","key":"891_CR8","doi-asserted-by":"publisher","first-page":"2362","DOI":"10.1007\/s10461-016-1616-2","volume":"21","author":"LG Johnston","year":"2017","unstructured":"Johnston LG, Bonilla L, Caballero T, Rodriguez M, Dolores Y, de la Rosa MA, et al. Associations of HIV testing, sexual risk and access to prevention among female sex Workers in the Dominican Republic. AIDS Behav. 2017;21(8):2362\u201371.","journal-title":"AIDS Behav"},{"key":"891_CR9","volume-title":"Global coalition on women and AIDS, young positives. Report card: HIV prevention for girls and young women - Dominican Republic","author":"International Planned Parenthood Federation, United Nations Population Fund","year":"2009","unstructured":"International Planned Parenthood Federation, United Nations Population Fund. Global coalition on women and AIDS, young positives. Report card: HIV prevention for girls and young women - Dominican Republic. London: International Planned Parenthood Federation; 2009."},{"issue":"14","key":"891_CR10","doi-asserted-by":"publisher","first-page":"1879","DOI":"10.1097\/00002030-199814000-00020","volume":"12","author":"TH Brewer","year":"1998","unstructured":"Brewer TH, Hasbun J, Ryan CA, Hawes SE, Martinez S, Sanchez J, et al. Migration, ethnicity and environment: HIV risk factors for women on the sugar cane plantations of the Dominican Republic. AIDS Lond Engl. 1998;12(14):1879\u201387.","journal-title":"AIDS Lond Engl"},{"issue":"12","key":"891_CR11","doi-asserted-by":"publisher","first-page":"1637","DOI":"10.1080\/09540121.2011.565154","volume":"23","author":"D Sears","year":"2011","unstructured":"Sears D, Cabrera C, Ortiz F, Anderson B, Stein M. Sexual risk behavior among HIV-positive patients at an urban clinic in Santiago, Dominican Republic. AIDS Care. 2011;23(12):1637\u201343.","journal-title":"AIDS Care"},{"issue":"4","key":"891_CR12","first-page":"364","volume":"11","author":"C Warren","year":"1999","unstructured":"Warren C. Geographical variations in AIDS knowledge and attitude among adolescent girls of Jamaica. AIDS Educ Prev N Y. 1999;11(4):364\u201372.","journal-title":"AIDS Educ Prev N Y"},{"issue":"2","key":"891_CR13","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1007\/s11904-014-0199-7","volume":"11","author":"JP Figueroa","year":"2014","unstructured":"Figueroa JP. Review of HIV in the Caribbean: significant progress and outstanding challenges. Curr HIV\/AIDS Rep. 2014;11(2):158\u201367.","journal-title":"Curr HIV\/AIDS Rep"},{"issue":"4","key":"891_CR14","doi-asserted-by":"publisher","first-page":"e123","DOI":"10.1097\/QAI.0000000000000315","volume":"67","author":"LA Sowah","year":"2014","unstructured":"Sowah LA, Turenne FV, Buchwald UK, Delva G, Mesidor RN, Dessaigne CG, et al. Influence of transportation cost on long-term retention in clinic for HIV patients in rural Haiti. J Acquir Immune Defic Syndr 1999. 2014;67(4):e123\u201330.","journal-title":"J Acquir Immune Defic Syndr 1999"},{"issue":"7","key":"891_CR15","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1007\/s10461-010-9781-1","volume":"15","author":"J Harris","year":"2011","unstructured":"Harris J, Pillinger M, Fromstein D, Gomez B, Garris I, Kanetsky PA, et al. Risk factors for medication non-adherence in an HIV infected population in the Dominican Republic. AIDS Behav. 2011;15(7):1410\u20135.","journal-title":"AIDS Behav"},{"issue":"Suppl 1","key":"891_CR16","doi-asserted-by":"publisher","first-page":"S9","DOI":"10.1080\/09540120500120955","volume":"17","author":"JA Inciardi","year":"2005","unstructured":"Inciardi JA, Syvertsen JL, Surratt HL. HIV\/AIDS in the Caribbean Basin. AIDS Care. 2005;17(Suppl 1):S9\u201325.","journal-title":"AIDS Care"},{"issue":"4","key":"891_CR17","doi-asserted-by":"publisher","first-page":"1748","DOI":"10.1353\/hpu.2014.0190","volume":"25","author":"K Brooks","year":"2014","unstructured":"Brooks K, Laws MB, Wilson I. Allocating HIV treatment to the adherent: a qualitative study of patient perceptions of their HIV care in the Dominican Republic. J Health Care Poor Underserved. 2014;25(4):1748\u201362.","journal-title":"J Health Care Poor Underserved"},{"issue":"6","key":"891_CR18","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1080\/09540121.2016.1160027","volume":"28","author":"PJ Fleming","year":"2016","unstructured":"Fleming PJ, Barrington C, Perez M, Donastorg Y, Kerrigan D. HIV testing, care, and treatment experiences among the steady male partners of female sex workers living with HIV in the Dominican Republic. AIDS Care. 2016;28(6):699\u2013704.","journal-title":"AIDS Care"},{"key":"891_CR19","volume-title":"Pan American health organization HIV biennial report 2008\u20132009","author":"WHO, PAHO","year":"2011","unstructured":"WHO, PAHO. Pan American health organization HIV biennial report 2008\u20132009. Washington DC: World Health Organization; 2011."},{"key":"891_CR20","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1186\/s12889-015-2432-8","volume":"15","author":"MM Jimenez","year":"2015","unstructured":"Jimenez MM, Andrade FCD, Raffaelli M, Iwelunmor J. Heterosexual transmission of HIV in the Dominican Republic: gendered indicators are associated with disparities in condom use. BMC Public Health. 2015;15:1161.","journal-title":"BMC Public Health"},{"issue":"10","key":"891_CR21","doi-asserted-by":"publisher","first-page":"1970","DOI":"10.1007\/s10461-014-0792-1","volume":"18","author":"SN Patel","year":"2014","unstructured":"Patel SN, Wingood GM, Kosambiya JK, McCarty F, Windle M, Yount K, et al. Individual and interpersonal characteristics that influence male-dominated sexual decision-making and inconsistent condom use among married HIV serodiscordant couples in Gujarat, India: results from the positive Jeevan Saathi study. AIDS Behav. 2014;18(10):1970\u201380.","journal-title":"AIDS Behav"},{"issue":"1","key":"891_CR22","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1111\/j.1471-6402.2009.01538.x","volume":"34","author":"L Rosenthal","year":"2010","unstructured":"Rosenthal L, Levy SR. Understanding women\u2019s risk for HIV infection using social dominance theory and the four bases of gendered power. Psychol Women Q. 2010;34(1):21\u201335.","journal-title":"Psychol Women Q"},{"issue":"3","key":"891_CR23","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1007\/s10461-007-9263-2","volume":"12","author":"K Ashburn","year":"2008","unstructured":"Ashburn K, Kerrigan D, Sweat M. Micro-credit, women\u2019s groups, control of own money: HIV-related negotiation among partnered Dominican women. AIDS Behav. 2008;12(3):396\u2013403.","journal-title":"AIDS Behav"},{"issue":"4","key":"891_CR24","first-page":"619","volume":"35","author":"C Puentes-Markides","year":"1992","unstructured":"Puentes-Markides C. Women and access to health care. Soc Sci Med 1982. 1992;35(4):619\u201326.","journal-title":"Soc Sci Med 1982"},{"issue":"12","key":"891_CR25","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1111\/1471-0528.12680","volume":"121","author":"R Kreitchmann","year":"2014","unstructured":"Kreitchmann R, Li SX, Melo VH, Fernandes Coelho D, Watts DH, Joao E, et al. Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: a cohort study. BJOG Int J Obstet Gynaecol. 2014;121(12):1501\u20138.","journal-title":"BJOG Int J Obstet Gynaecol"},{"issue":"3","key":"891_CR26","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.ijgo.2013.09.013","volume":"123","author":"SL Gottlieb","year":"2013","unstructured":"Gottlieb SL, Newman LM, Amin A, Temmerman M, Broutet N. Sexually transmitted infections and women\u2019s sexual and reproductive health. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2013;123(3):183\u20134.","journal-title":"Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet"},{"key":"891_CR27","volume-title":"Global prevalence and incidence of selected curable sexually transmitted infections \u2013 2008","author":"WHO","year":"2012","unstructured":"WHO. Global prevalence and incidence of selected curable sexually transmitted infections \u2013 2008. Geneva: World Health Organization; 2012."},{"key":"891_CR28","volume-title":"Demographic and health surveys methodology - questionnaires: household, Woman\u2019s, and Man\u2019s","author":"ICF International","year":"2011","unstructured":"ICF International. Demographic and health surveys methodology - questionnaires: household, Woman\u2019s, and Man\u2019s. Calverton, MD: Demographic and Health Surveys Program, U.S. Agency for International Development; 2011."},{"issue":"6","key":"891_CR29","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1111\/j.1553-2712.2010.00773.x","volume":"17","author":"ST Wilber","year":"2010","unstructured":"Wilber ST, Fu R. Risk ratios and odds ratios for common events in cross-sectional and cohort studies. Acad Emerg Med. 2010;17(6):649\u201351.","journal-title":"Acad Emerg Med"},{"issue":"7","key":"891_CR30","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1093\/aje\/kwh090","volume":"159","author":"G Zou","year":"2004","unstructured":"Zou G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004 Apr 1;159(7):702\u20136.","journal-title":"Am J Epidemiol"},{"key":"891_CR31","volume-title":"Stata\/SE 13.1","author":"StataCorp","year":"2013","unstructured":"StataCorp. Stata\/SE 13.1. College Station: StataCorp LP; 2013."},{"issue":"2","key":"891_CR32","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","volume":"42","author":"PA Harris","year":"2009","unstructured":"Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377\u201381.","journal-title":"J Biomed Inform"},{"issue":"1","key":"891_CR33","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1080\/21642850.2014.905209","volume":"2","author":"S-AR Charlery","year":"2014","unstructured":"Charlery S-AR. Research conducted on Caribbean women\u2019s perceived human immunodeficiency virus risks: a narrative review and methodological critique. Health Psychol Behav Med. 2014;2(1):541\u201354.","journal-title":"Health Psychol Behav Med"},{"issue":"3","key":"891_CR34","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1515\/IJAMH.2008.20.3.275","volume":"20","author":"J Minaya","year":"2008","unstructured":"Minaya J, Owen-Smith A, Herold J. The impact of sex education on HIV knowledge and condom use among adolescent females in the Dominican Republic. Int J Adolesc Med Health. 2008;20(3):275\u201382.","journal-title":"Int J Adolesc Med Health"},{"issue":"2","key":"891_CR35","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/s10900-010-9310-1","volume":"36","author":"EF Koku","year":"2011","unstructured":"Koku EF. Desire for, and uptake of HIV tests by Ghanaian women: the relevance of community level stigma. J Community Health. 2011;36(2):289\u201399.","journal-title":"J Community Health"},{"key":"891_CR36","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1111\/j.1749-6632.2000.tb05474.x","volume":"918","author":"HM Coovadia","year":"2000","unstructured":"Coovadia HM. Access to voluntary counseling and testing for HIV in developing countries. Ann N Y Acad Sci. 2000;918:57\u201363.","journal-title":"Ann N Y Acad Sci"},{"issue":"2","key":"891_CR37","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1080\/09540120600774297","volume":"19","author":"N Abell","year":"2007","unstructured":"Abell N, Rutledge SE, McCann TJ, Padmore J. Examining HIV\/AIDS provider stigma: assessing regional concerns in the islands of the eastern Caribbean. AIDS Care. 2007;19(2):242\u20137.","journal-title":"AIDS Care"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-020-0891-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12905-020-0891-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-020-0891-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T05:55:42Z","timestamp":1612763742000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-020-0891-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,7]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["891"],"URL":"https:\/\/doi.org\/10.1186\/s12905-020-0891-2","relation":{},"ISSN":["1472-6874"],"issn-type":[{"type":"electronic","value":"1472-6874"}],"subject":[],"published":{"date-parts":[[2020,2,7]]},"assertion":[{"value":"4 October 2017","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Consent to participant was not applicable given that the needs assessment data were not collected for research purposes. Permission was obtained from the original needs assessment team to access and analyze the needs assessment data, The Miriam Hospital Institutional Review Board approved retrospective review of needs assessment data for research.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"21"}}