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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Heterosexual transmission of HIV in the Dominican Republic: gendered indicators are associated with disparities in condom use

BMC Public Health > Ausgabe 1/2015
Michelle M. Jimenez, Flavia C. D. Andrade, Marcela Raffaelli, Juliet Iwelunmor
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2432-8) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

All authors made substantial intellectual contributions during manuscript preparation. MJ designed the study, conducted the statistical analysis, and drafted the manuscript. FA and MR provided valuable feedback on data analysis and the methodological approach. FA assisted in revising the statistical analysis. FA, MR, and JI edited and proofread the subsequent versions of the manuscript and tables. MR edited and proofread the final version of the manuscript. All authors read and approved the final manuscript.



Gendered dynamics in heterosexual relationships compromise women’s self-efficacy and increase their vulnerability to acquiring HIV. This study examines the impact of socioeconomic determinants, media exposure, and sexual expectations on sexual behaviors of men and women in the Dominican Republic (DR).


We analyzed cross-sectional data from 51,018 adults in the Dominican Republic age 15 to 45 years collected by the Demographics and Health Survey (DHS) in 2007. Measures included demographic and socioeconomic indicators, social exposures, sexual expectations and sexual behaviors. Logistic regression models explored gender differences in condom use.


Study findings indicated that women were less likely to use a condom at last intercourse than men (odds ratio [OR] = 0.29; 95 % CI = 0.27, 0.31). Among men, secondary (OR = 1.43; 95 % CI = 1.16, 1.76) and higher education (OR = 1.58; 95 % CI = 1.25, 2.00), being in the richest quintile (OR = 1.25; 95 % CI = 1.07, 1.47), and living in a female-headed household (OR = 1.13; 95 % CI 1.03, 1.23) increased the likelihood of condom use. Compared to never married men, currently and formerly married men were less likely to use condoms (OR = 0.03; 95 % CI = 0.03, 0.04 and OR = 0.67; 95 % CI = 0.60, 0.75, respectively). The odds of condom use increased for young women 15–19 years old in comparison with women age 30–34 years, but decreased as they grew older. For women, being in the richer quintile (OR = 1.28; 95 % CI = 1.06, 1.54), living in a female-headed household (OR = 1.26; 1.12, 1.41), and having good access to media (OR = 1.24; 95 % CI = 1.12, 1.42) increased the likelihood of condom use. Being currently married or formerly married and living in rural areas decreased such likelihood among women.


Study findings provide evidence that, in the DHS, socioeconomic and cultural differences between men and women affects condom use. Efforts to reduce HIV transmission within heterosexual relationships in the DR call for tailored, gender-specific interventions that take into account gender differences of power and sexual behaviors.
Additional file 1: Tables for nested logistic models. The additional file 1 is an Excel document which contains three separate sheets, each one with a different table that displays the results of the nested analyses for condom use: Table S5 displays the nested logistic models for condom use among all Dominicans age 15 to 45 years in the sample. Table S6 displays the disaggregated nested logistic models for condom use by men. Table S5 displays the disaggregated nested logistic models for condom use by women. (XLSX 37 kb)
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