Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109, USA.
Qual Health Res. 2012 Jan;22(1):89-102. doi: 10.1177/1049732311419865. Epub 2011 Aug 22.
The Dominican Republic has high rates of HIV infection and alcohol consumption. Unfortunately, little research has been focused on the broader sources of the synergy between these two health outcomes. We draw on syndemic theory to argue that alcohol consumption and sexual risk behavior are best analyzed within the context of culture and economy in Caribbean tourism spaces, which produce a synergy between apparently independent outcomes. We sampled 32 men and women working in the tourism industry at alcohol-serving establishments in Sosúa, Dominican Republic. Interviewees described alcohol consumption as an implicit requirement of tourism work, tourism industry business practices that foster alcohol consumption, and an intertwining relationship between alcohol and sexual commerce. The need to establish relationships with tourists, combined with the overconsumption of alcohol, contributed to a perceived loss of sexual control, which participants felt could impede condom use. Interventions should incorporate knowledge of the social context of tourism areas to mitigate the contextual factors that contribute to HIV infection and alcohol consumption among locals.
多米尼加共和国的艾滋病毒感染率和酒精消费水平都很高。不幸的是，很少有研究关注这两种健康结果之间协同作用的更广泛来源。我们借鉴综合疾病理论，认为在加勒比旅游空间的文化和经济背景下，对酒精消费和性风险行为进行分析最为合适，因为这些空间会使两种看似独立的结果产生协同作用。我们在多米尼加共和国索苏亚的酒吧中对 32 名从事旅游行业的男性和女性进行了抽样调查。受访者将饮酒描述为旅游工作的一项隐性要求、促进饮酒的旅游行业商业惯例，以及酒精和性交易之间的交织关系。与游客建立关系的需求，再加上酒精的过度消费，导致了性控制的明显丧失，参与者认为这可能会阻碍使用避孕套。干预措施应该纳入对旅游区社会背景的了解，以减轻导致当地人感染艾滋病毒和酗酒的环境因素。
