This article reviews HIV/AIDS epidemiological data and recent research conducted in the Dominican Republic, with a focus on explaining the variability in estimated seroincidence and prevalence within the country. HIV seroprevalence estimates range from 1.0% (in the general population) to 11.0% among men who have sex with men (MSM). Some have indicated that the highest HIV seroprevalence occurs in Haitian enclaves called bateyes (US Agency for International Development [USAID], 2008), which are migrant worker shantytowns primarily serving the sugar industry in the Dominican Republic. Others report higher or comparable rates to the bateyes in areas related to the tourism and sex industries. As in other Caribbean and Latin American countries, reported HIV transmission in the Dominican Republic is predominantly due to unprotected heterosexual sex and the infection rate has been increasing disproportionally among women. The Dominican Republic represents two thirds of the Hispaniola island; the western one third is occupied by Haiti, the nation with the highest HIV prevalence in the western hemisphere. Although data is limited, it shows important differences in seroprevalence and incidence between these two countries, but commonalities such as poverty, gender inequalities, and stigma appear to be pivotal factors driving the epidemic. This article will discuss these and other factors that may contribute to the HIV epidemic in the Dominican Republic, as well as highlight the gaps in the literature and provide recommendations to guide further work in this area, particularly in the role of governance in sustainable HIV prevention.

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Objective Identifying and understanding determinants of alcohol use behavior among Hispanic immigrants is an increasingly significant public health concern. Although prior research has examined associations of cultural stressors with alcohol use among Hispanics, few studies have tested these associations among recent adult immigrants. As such, this study aimed to (a) examine the association of immigration stress on alcohol use severity among recently immigrated Hispanic adults (≤ 1 year in the U.S.); and (b) examine the moderating effects of gender, immigration status, and social support. Method A hierarchical multiple regression and moderation analyses were conducted on a sample of 527 participants in South Florida. Results Results indicated that after controlling for demographic variables, pre-immigration drinking behavior, and dimensions of social support, the association of higher immigration stress with higher alcohol use severity was statistically significant. Moderation analyses indicated that immigration stress had a statistically significant association with alcohol use severity among men, but not among women. Also, dimensions of social support consistently reduced the deleterious effect of immigration stress on alcohol use severity. Conclusion This study adds to the scarce literature on cultural stressors and alcohol use among recent Hispanic immigrants. Findings suggest that it may be important to design gender-specific interventions and that increasing levels of social support may offset the effects of immigration stress on alcohol use.

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The escalation of alcohol use among some Latino immigrant groups as their time in the United States increases has been well-documented. Yet, little is known about the alcohol use behaviors of Latino immigrants prior to immigration. This prospective longitudinal study examines pre- to post-immigration alcohol use trajectories among a cohort of recent Latino immigrants. Retrospective pre-immigration data were collected at baseline from a sample of 455 Cuban, South American and Central American Latinos ages 18–34 who immigrated to the U.S. less than one year prior. Two follow-up assessments (12 months apart) reported on their post-immigration alcohol use in the past 90 days. We hypothesized (a) overall declines in pre- to post-immigration alcohol among recent Latino immigrants and (b) gender/documentation specific effects, with higher rates of alcohol use among males and undocumented participants compared to their female and documented counterparts. Growth curve analyses revealed males had higher levels of pre-immigration alcohol use with steeper declines in post-immigration alcohol use compared to females. Declines in alcohol use frequency were observed for documented, but not undocumented males. No changes in pre- to post-immigration alcohol use were found for documented or undocumented females. This study contributes to the limited knowledge of pre- to post-immigration alcohol use patterns among Latinos in the United States. Future research is needed to identify social determinants associated with the alcohol use trajectories of recent Latino immigrants, as it may inform prediction, prevention, and treatment of problem-drinking behaviors among the largest and fastest growing ethnic minority in the United States.

Although the risks and protective processes influencing substance use behaviors of adult Latinos have been increasingly examined in the literature, substance abuse among adult Latinas remains a relatively understudied area. This study examined associations between mother-daughter attachment and substance abuse among 158 Latina mothers and their adult daughters (N = 316). Dyads of mothers and daughters were categorized into four groups: (a) mother/daughter both drug or alcohol abusers (Dyad 1), (b) mother abuser and daughter non-abuser (Dyad 2), (c) mother non-abuser and daughter abuser (Dyad 3), and (d) mother/daughter both non-abusers (Dyad 4). Dyad 1 participants reported lower levels of attachment to each other than all other types of dyads. Participants born in the U.S. reported more substance abuse than their non-U.S. born counterparts. Future longitudinal research is recommended to determine the presence of a mother-daughter attachment threshold that, if established early and maintained, may act as a protective mechanism against the intergenerational co-occurrence of substance abuse among adult Latinas.

Some potential clinical implications may be that strengthening family cohesion may enhance levels of social support, and in turn, lower alcohol use severity among adult Hispanic immigrants. Furthermore, strengthening family cohesion may be especially beneficial to men in efforts to lower levels of alcohol use severity.

Associations among mother-daughter attachment, mother and daughter substance abuse, and daughter's sexual behavior under the influence of drugs and alcohol were investigated among 158 adult U.S. Latina daughters. Latina daughters were sampled from four mother-daughter dyad types: substance abusing mother and daughter, substance abusing mother only, substance abusing daughter only, and nonsubstance-abusing mother and daughter. Substance abusing daughters with substance abusing mothers, and daughters who were less strongly attached to their mothers, reported more sex under the influence of drugs. Age, marital status, substance abuse, and mother's substance abuse all influenced the daughter's sex under the influence of alcohol. An unexpected positive association between attachment and sex under the influence of alcohol was found for daughters who were more closely attached to a substance abusing mother. Implications for future research, and HIV/AIDS and drug prevention and treatment programs for Latinas are discussed.