Presentation on theme: "The Effect of Withholding Information on HIV Risk Behavior among Dominican Male Sex Workers Mark B. Padilla, MPH, PhD Sociomedical Sciences, Mailman School."— Presentation transcript:
The Effect of Withholding Information on HIV Risk Behavior among Dominican Male Sex Workers Mark B. Padilla, MPH, PhD Sociomedical Sciences, Mailman School of Public Health Columbia University Santo Domingo - March, 2004 With financial support from: National Science Foundation, Wenner-Gren Foundation for Anthropological Research, Fulbright IIE, Fogarty AITRP (Johns Hopkins), and USAID / DR ( AcciónSIDA ) Collaborating organization: Amigos Siempre Amigos, Inc. (ASA) Investigative team: Leonardo Sánchez, Martha Arredondo, Armando Matiz (Photo: Parque Colón, Zona Colonial, Santo Domingo)
(Photo: El Conde, Santo Domingo) Methodology 3 years of multi-sited ethnographic fieldwork Research association with the NGO Amigos Siempre Amigos (ASA) Combined qualitative / quantitative methodology Research phases: 1. Exploratory: Description, mapping of sex work sites; informal interviewing; focus groups 2. Survey of 200 male sex workers, emphasizing: - Socio-demographic profile - Terms of self-identification - Social norms about sex work - Sexual behavior and condom use - Affective and emotional bonds - Substance use history - Migration experiences - Measures of selected co-factors of HIV / STD risk 3. 98 audiotaped semi- structured interviews: - Childhood experiences / traumas - Relations with parents & siblings - Stigma-management techniques - Initiation into sex work - Relations with girlfriends, spouses, and children - Stories of worst and best clients - Beliefs, fears, behaviors related to HIV/AIDS - Future aspirations / plans
Methodology Continuous participant observation, informal interviewing, and ethnographic note-taking throughout research (Photo: El Conde, Santo Domingo)
Eduardo: Well, yeah, but at the end of it all, I came back with my acting, because I did a drama for her, an entire role… you understand? And to stay in good stead, I told her that no, that it [the infidelity] was with a woman, that what was going on was that I didnt want to tell her, for this or that reason. [In voice of girlfriend] I knew that it was a woman! That was my means… Or my trick. I used an illusion, thats it… I performed a part for her: No, it was a woman! I didnt want to say anything to her, because I know how she is… [In voice of girlfriend] It better not be a homosexual! Careful, you hear! But thats how it was… We went eight days without talking to each other. Thats how it was.
(Photo: Beach adjacent to tourist hotels, Boca Chica) Tourist arrivals by year
(Photo: Malecón, Santo Domingo) bisexual bridge Homo Hetero Figure 6.1: Model of HIV transmission based on the bisexual bridge HIV Non- disclosers Exclusive opposite- sex activity Exclusive same-sex activity Figure 6.2: Model of HIV transmission in a hypothetical bisexually-driven epidemic Male and female partners
(Photo: Monument to the Mirabal Sisters, Santo Domingo)