High-Risk Sexual Behavior, HIV/STD Prevalence, and Risk Predictors in the Social Networks of Young Roma (Gypsy) Men in Bulgaria

Yuri A. Amirkhanian, Jeffrey A. Kelly, Elena Kabakchieva, Radostina Antonova, Sylvia Vassileva, Wayne J. DiFranceisco, Timothy L. McAuliffe, Boyan Vassilev, Elena Petrova, Roman A. Khoursine

Roma (Gypsies), the largest and most disadvantaged ethnic minority group in Europe, are believed to be vulnerable to HIV/AIDS. This study's aim was to examine HIV risk in 6 Roma male sociocentric networks (n = 405 men) in Bulgaria. Participants were interviewed concerning their risk practices and tested for HIV/STDs. High-risk sexual behaviors were common. Over 57% of men had multiple sexual partners in the past 3 months. Over one-third of men reported both male and female partners in the past year. Condom use was low. Greater levels of sexual risk were associated with lower intentions and self-efficacy for using condoms, drug use, having male partners, knowing HIV-positive persons, and having higher AIDS knowledge but no prior HIV testing. Two men had HIV infection, 3.7% gonorrhea, and 5.2% chlamydia. HIV prevention interventions directed toward high-risk social networks of Roma are needed before HIV infection becomes more widely established.