In the Dominican Republic, HIV is considered a pandemic issue, meaning it is continuously occurring in that population. HIV is a virus that attacks a persons CD4 cells, which are essentially the immune cells; they are the cells that activate the immune response when an antigen is detected. I normal healthy person will have anywhere from 500-1,000 CD4 cells/mm^3. If you have been diagnosed with HIV, you generally will not begin to treat the disease until your CD4 cells are below 350 cells/mm^3. When I traveled to the Dominican Republic in May, we visited an HIV clinic, and met with several people who had been diagnosed with HIV. I learned that because of financial reasons and lack of medication, in the Dominican Republic, those with HIV are not treated for their disease until their CD4 counts are below 200 cells/mm^3, which is significantly low, is likely why so many people in the Dominican Republic often die sooner than those with HIV in the United States. Without having much of an immune response, many people in the Dominican Republic HIV die from other diseases, especially tuberculosis. Although the rates of HIV have decreased somewhat in the last few years, there is still much more that needs to be done in order to significantly decrease the incidence of the virus. The government is responding by providing HIV/AIDS counseling and testing and educating those in the Dominican Republic about safe sex and the serious effects of HIV. Mark Padilla, a medical anthropologist, is currently conducting a 5 year study on migration, tourism, and the HIV/drug syndemic to examine the social and structural factors that contribute to HIV and drug use specifically in tourist areas. His goal is to be able to develop an intervention program to improve the health of the Dominican Republic citizens who work in tourist areas.
Padilla, Mark, Guilamo-Ramos, V., Bouris, A., and Matiz-Reyes, A. “HIV/AIDS and Tourism in the Caribbean: An Ecological Systems Perspective.” American Journal of Public Health. 100(1):70-77.
Padilla, Mark. “The Embodiment of Tourism among Bisexually-behaving Dominican Male Sex Workers.” Archives of Sexual Behavior. 37:5: 783-793.