High burden of sexually transmitted infections among under-resourced populations in the Dominican Republic

Silvia Amesty; Rafael Perez-Figueroa; Samantha Stonbraker; Mina Halpern; Yeycy Donastorg; Martha Perez-Mencia; Flavia Lantigua; Leidy Soriano; Pamela Baez-Caraballo; Jeffrey Gilbert; Frank Buccini; James Sharp; Brian Hernandez; Jonathan Gelfond; Ethan Cardwell; Catherine Nicholas; Kelsey A Egan; Angelina Gomes; Elizabeth Van Dyke; Stephen W Nicholas; Marc Grodman; Barbara S Taylor

doi:10.1177/20499361231193561

High burden of sexually transmitted infections among under-resourced populations in the Dominican Republic

Ther Adv Infect Dis. 2023 Aug 31:10:20499361231193561. doi: 10.1177/20499361231193561. eCollection 2023 Jan-Dec.

Authors

Silvia Amesty¹, Rafael Perez-Figueroa², Samantha Stonbraker³, Mina Halpern⁴, Yeycy Donastorg⁵, Martha Perez-Mencia⁵, Flavia Lantigua⁵, Leidy Soriano⁴, Pamela Baez-Caraballo⁴, Jeffrey Gilbert⁶, Frank Buccini⁶, James Sharp⁶, Brian Hernandez⁷, Jonathan Gelfond⁷, Ethan Cardwell⁸, Catherine Nicholas⁹, Kelsey A Egan¹⁰, Angelina Gomes¹¹, Elizabeth Van Dyke¹², Stephen W Nicholas¹³, Marc Grodman¹⁴, Barbara S Taylor⁷

Affiliations

¹ Department of Medical Humanities and Ethics, Center for Family and Community Medicine, Mailman School of Public Health, Columbia University Irving Medical Center, 10 Ft. Washington Avenue, PH, New York, NY 10032-8300, USA.
² Department of Urban-Global Health, Rutgers University School of Public Health, Piscataway, NJ, USA.
³ University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA.
⁴ Clínica de Familia La Romana, La Romana, Dominican Republic.
⁵ Instituto Dermatológico de Cirugía y Piel Humberto Borgart, Santo Domingo, Dominican Republic.
⁶ BioReference Laboratories, Elmwood Park, NJ, USA.
⁷ Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA.
⁸ Melbourne School of Global and Population Health, University of Melbourne, Melbourne, VIC, Australia.
⁹ University of Rochester Medical Center, Golisano Children's Hospital, Rochester, NY, USA.
¹⁰ Boston University School of Medicine, Boston, MA, USA.
¹¹ Grossman School of Medicine, New York University, New York, NY, USA.
¹² Children's Hospital Los Angeles, Los Angeles, CA, USA.
¹³ Children's Global Health Fund, Mt Kisco, NY, USA.
¹⁴ Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.

Abstract

Background: Sexually transmitted infections (STIs) are a major health issue, exacerbated by limited financial and infrastructural resources in developing countries.

Methods: Prevalence of STIs was assessed in two urban centers of the Dominican Republic (DR) among populations at high risk for STIs: pregnant youth, men who have sex with men (MSM), trans women (TG), batey residents, female sex workers, and people living with human immunodeficiency virus (HIV). We conducted a cross-sectional survey and biological specimen collection to screen for Chlamydia trachomatis, Neisseria gonorrhea, Mycoplasma genitalium, Trichomonas vaginalis (trichomoniasis), Treponema pallidum (syphilis), HIV, hepatitis B and C, and human papillomavirus (HPV) among at-risk populations between 2015 and 2018. Ureaplasma urealyticum testing was also conducted even though it is not considered a STI. A non-probability community sample was recruited. Descriptive statistics examined the prevalence of STIs by population.

Results: A total of 1991 subjects participated in the study. The median age was 26 years (range: 18-65). Most participants were female (65.3%), heterosexual (76.7%), and were not partnered (55.7%). Most of the participants reported unprotected vaginal sex in the last 6 months (54%); among MSM and TG almost half of the participants reported unprotected anal sex in the last 6 months and 17.6% reported drug use in the last 6 months. Almost half of the participants (49%) tested positive for one or more STIs. The most prevalent STI was Chlamydia trachomatis (12.8%), and human papillomavirus (11.9%). Among transgender women, 65.3% tested positive for an STI, 64.8% of female sex workers tested positive for an STI, and 53.8% of pregnant adolescents tested positive for an STI.

Conclusion: There is a high prevalence of STIs among key and under resourced populations in the DR. Our findings highlight the need to conduct further research to optimize prevention and care strategies for structurally vulnerable and under resourced populations in the DR.

Keywords: key populations; prevalence of STIs; sexually transmitted infections.