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Trans R Soc Trop Med Hyg. 2019 Mar 20. pii: trz012. doi: 10.1093/trstmh/trz012. [Epub ahead of print]

Human T-cell lymphotropic virus 1/2 and human immunodeficiency virus antibodies identification among transactional sex workers and drug users in the Dominican Republic.

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Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Calle Majoma 13, Los Rios, Santo Domingo, Dominican Republic.
Centro de Orientación e Investigación Integral (COIN), Calle Anibal de Espinosa 352, Santo Domingo, Dominican Republic.
University of Alabama at Birmingham (UAB), School of Public Health, Department of Health Care Organization and Policy, 1720 2nd Avenue South, Birmingham, AL.
McGill University Health Centre: Glenn Site, Research Institute, Block E Suite EM 3-3232, Mezzanine 3M, 1001 Boulevard Décaire, Montreal, Quebec, Canada.



Human immunodeficiency virus (HIV) increases the risk of acquiring human T-cell lymphotropic virus (HTLV) and subsequently HTLV's progression to tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). Existing data have exclusively reported generalized rates of HIV and HTLV-1 chronic viral infections in the Dominican Republic. To our knowledge, no published studies have focused on the rates of HTLV-1/2 in transactional sex workers and drug users, both higher risk groups, in the Dominican Republic.


From December 2012 to April 2013 we conducted a study to estimate the seroprevalence of HTLV-1/2 immunoglobulin G (IgG) and HIV antibodies among transactional sex workers and intravenous drug users in Santo Domingo, Dominican Republic. Serological status was analysed with behaviour and demographic data.


We collected and analysed plasma from 200 participants with a mean age of 27.4 y in men and 25.2 y in women. The overall weighted seroprevalence of HTLV-1/2 IgG antibodies was 13.91% (95% CI 7.59 to 20.23) in men and 10.59% (95% CI 4.05 to 17.13) in women. The overall weighted seroprevalence of HIV-1 was 13.91% (95% CI 7.59 to 20.23%) in men and 17.65% (95% CI 9.55 to 25.75) in women. Male intravenous drug users had an exceptionally high rate of HTLV-positive HIV co-infection, at 75% (95% CI 44.99 to 105.01). Although there an association has been found between HTLV/HIV co-infections and sex work, the adjusted odds revealed a confounding role of HIV infection.


The results highlight the urgent need for enhanced public health preventive strategies among high-risk populations in the Dominican Republic and other resource-constrained Caribbean settings, as well as global adoption of routine screening for HTLV-associated infections, particularly in these high-risk, underserved populations.


Dominican Republic; HIV; HTLV; drug users; sex workers; transactional sex


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