The state of HIV/AIDS in the Dominican Republic: Guarded optimism amidst sustainability concerns

The Dominican Republic (DR) is often portrayed as a country where a proactive response to HIV/AIDS occurred early on in the course of the epidemic, allowing for significant control of viral spread. In recent years many in the field of HIV prevention have specifically highlighted the apparent stabilization and/or decline in HIV prevalence in the DR and spoken with guarded optimism about the gains made within the country. Indeed, successful HIV prevention efforts have been implemented in larger cities within the country, particularly among vulnerable population groups such as female sex workers. What was thought in the early 1980s to be the beginning of a generalized HIV/AIDS epidemic has fortunately not come to fruition for this Caribbean nation. Additionally, after many years of struggle on the part of people living with HIV/AIDS (PLWHA), social activists, and non-governmental organizations (NGOs), access to HIV treatment and care is finally and slowly occurring. The ability of the DR to sustain and expand ongoing HIV prevention and care efforts beyond larger cities to less frequently reached geographic areas remains to be seen. Recent uncertainty regarding the flow of funding from international donors has only added to such concerns. These trends highlight the need for continued commitment from both the Dominican government and civil society to ensure that the achievements made to date are not lost and that current gaps in HIV/AIDS programming and policy are effectively addressed.