ABSTRACT:
HIV care in the Dominican Republic is a critical public health issue for Haitian migrants and Dominicans of Haitian descent, a population disproportionately affected by structural vulnerability, social exclusion, and barriers to healthcare access (1,2). Migration dynamics, stigma, and legal insecurity contribute to delayed diagnosis, poor retention in care, and suboptimal treatment outcomes among this population, posing challenges to national and regional HIV control efforts (3). Addressing HIV care for Haitians in the Dominican Republic is therefore essential for advancing health equity and achieving global HIV targets (4). This study examined the provision of HIV care in Santiago de los Caballeros, focusing on a public hospital that provides comprehensive services to patients living with HIV. While the primary objective was to gain a general understanding of HIV care delivery within this clinical setting, the study incorporated targeted questions to explore experiences and challenges related to HIV care among the Haitian population. Qualitative data were collected through interviews with healthcare providers and laboratory personnel directly involved in HIV diagnosis, treatment, and monitoring. These discussions identified several recurring barriers affecting engagement and retention in care among Haitian patients. Language barriers, particularly the limited availability of Haitian Creole resources, were reported as a significant obstacle to effective communication regarding diagnosis, treatment adherence, and follow-up care. Cultural differences in health beliefs and healthcare utilization further complicate patient-provider interactions. In addition, migration within the Dominican Republic, often occurring without advance notice due to employment instability or housing insecurity, frequently resulted in patients being lost to follow-up and interruptions in antiretroviral therapy. Participants highlighted strategies to improve HIV care continuity, including providing HIV related materials in Haitian Creole, using image-based communication tools, and strengthening community engagement to build trust in HIV care services.