[health menu] XI International Conference on AIDS
July 7-12, 1996

Brewer, Toye, Ryan, C.,
Sanchez, J., Hawes, S., Holmes, K.,
University of Washington; Seattle, WA., U.S.

Hasbun, J., Butler de Lister, M.,
AIDSCAP, Santo Domingo, DR

Constanzo, J., Lopez, J.,
Central Romana Sugar Estates, La Romana, DR


Migration, Ethnicity and Gender:
HIV Risk Factors For Women on the Sugar Cane Plantations (Bateyes) of the Dominican Republic (DR)


To determine risk factors for HIV infection among women living on the bateyes of large private sugar cane company in the DR (estimated off season adult population 18,500, 1.4 males:1 female).


23 of the 98 bateyes were randomly selected and visited by a mobile medical unit. Volunteers were interviewed, examined and tested for HIV/VDRL-FTA-ABS. Of 513 women approached, 509 volunteered from whom 492 with completed interviews and HIV testing are included in this analysis.


Subjects ranged in age from 16 to 72 years of age (median age 37). Fifty-three percent were born in Haiti, 36% in the bateyes of the DR and 12% elsewhere in the DR. Fifty-eight percent had no formal education and 87% were not generating income. Twenty percent acknowledged exchanging sex for money at some time but only 2.6% described themselves as prostitutes. Twenty-eight women (5.7%) were HIV seropositive, including 9.6% of women <35 years of age. By logistic regression analysis, HIV infection was independently associated with self description as a prostitute (OR 6.1, p=0.02) and with age <35 (OR 4.7, p=0.01). Nevertheless, 46% of the HIV-infected women reported only one or two lifetime sexual partners. For Haitian women, those coming to the DR alone or with a relative were more likely than those coming with a male partner to have HIV infection (OR 5.0, p=0.01; and OR 3.7, p=<0.01 respectively). Less than 4% of women reported condom use at last intercourse.


Women in the bateyes have a five-fold higher risk for HIV infection than that estimated for women in the DR in general, and a rate equal to that of DR female sex workers. Unequal sex ratios and lack of economic opportunities for women in the sugar cane industry make formalized prostitution and informal exchange of sex for money common survival strategies for these women. AIDS prevention should address condom promotion and distribution as well as employment opportunities and education for women.

Toye Brewer, MD
1001 Broadway, Suite 215
Seattle, WA 98122
Tel: (206)-720-4239; Fax: (206)-720-4209
Email: toye@u.washington.edu

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Created: July 16, 1996
Last modified: July 17, 1996

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