Evidence map›Paper›PMID 41651523›Full record

ArticleBMJ open2026

HIV diagnostic implementation in the Dominican Republic: an in-depth qualitative context analysis for health technology developers.

Kiara Lee, David Arango, Shamill Morel, Karla Sterling, Madina Agénor, Anubhav Tripathi, Claudia Rodriguez, Rochelle Rosen, Martha Sanchez

Abstract read
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Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kiara LeeRice360 Institute for Global Health Technologies, Rice University, Houston, Texas, USA kiara.lee.phd@gmail.com.ORCID http://orcid.org/0000-0001-5917-1515
David ArangoBrown University School of Public Health, Providence, Rhode Island, USA.ORCID http://orcid.org/0009-0008-3244-5326
Shamill MorelDepartamento de Oncológica Médica, Instituto Oncológico Regional del Cibao, Santiago de los Caballeros, Dominican Republic.
Karla SterlingLaboratorio Clínico, Hospital Regional Universitario José María Cabral y Baéz, Santiago de los Caballeros, Dominican Republic.
Madina AgénorDepartment of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID http://orcid.org/0000-0001-6675-8891
Anubhav TripathiCenter for Biomedical Engineering, Brown University School of Engineering, Providence, Rhode Island, USA.ORCID http://orcid.org/0000-0002-8915-2320
Claudia RodriguezClínica de Enfermedades por Daño Inmuológico, Hospital Regional Universitario José María Cabral y Baéz, Santiago de los Caballeros, Dominican Republic.
Rochelle RosenDepartment of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID http://orcid.org/0000-0003-1598-667X
Martha SanchezCleveland Clinic at Martin Health, Cleveland Clinic, Miami, Florida, USA.

Funding

Emerging Infectious Disease Scholars at Brown UniversityR25AI140490 · NIAID · BROWN UNIVERSITY · PI Silvia Shinpei Chiang · 2018 to 2026
$3.0M
NIAID NIH HHS R25 AI140490
6 · The paper itself

Abstract

objectivesTo understand the political, economic, social and technological facilitators and barriers in obtaining an HIV diagnosis to inform implementation strategies for HIV diagnostics in the Dominican Republic (DR).

designIn-depth, semi-structured qualitative interviews.

settingA high complexity public hospital in Santiago de los Caballeros, DR.

participantsA convenience and purposive sample of 36 internal medicine physicians and laboratory personnel involved in sample collection, sample analysis or oversight of biological sample analysis.

resultsUsing the Social Ecological Model, our results highlighted several interrelated barriers and facilitators to sample analysis at the individual (patient), interpersonal (interactions between laboratory personnel, physicians and patients), organisational (the hospital), community (Santiago de Los Caballeros) and societal (the DR) levels. Some key findings include the importance of psychological support in receiving an HIV diagnosis, how spoken language can be a barrier to care, how inconsistent access to laboratory supplies is a barrier for patients, laboratory personnel and clinicians, and the importance of government public health investment.

conclusionsEmploying qualitative methods to investigate a bioengineering challenge yielded rich data on the sociotechnical implementation context of HIV diagnostics in the DR. Several context-relevant suggestions were developed for HIV diagnostic developers which include incorporating psychological support into the diagnosis workflow, delivering information in multiple languages (ie, Haitian Creole and Spanish) and with non-stigmatising phrasing, working with the public sector to develop and implement technologies, and reducing the supply chain reliance on high-income countries to lessen delays in care. These findings can apply to other types of health technologies and settings and demonstrate the importance of utilizing human-centered design to understand implementation context and promote global health equity in health technology development and adoption.

Indexed as

HIV InfectionsHIV TestingDominican RepublicFemaleHealth Services AccessibilityHospitals, PublicHumansInterviews as TopicMaleQualitative ResearchdiagnosticsHIV & AIDShuman-centered designPUBLIC HEALTHPublic HospitalsQUALITATIVE RESEARCHsocial ecological model

Identifiers

PMID41651523
PMCPMC12887497

What OpenQuestion holds

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.