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

Abstract

Introduction 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. Methods Participants were interviewed concerning their risk practices and tested for HIV/STDs. Results 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. Discussion HIV prevention interventions directed toward high-risk social networks of Roma are needed before HIV infection becomes more widely established.

Lived experience of vulnerability from a Gypsy Roma Traveller perspective

“…, Amirkhanian et al . ) specifically focussing upon HIV and sexually transmitted infections. In addition, research by Masseria et al .…”

Roma Health: An Overview of Communicable Diseases in Eastern and Central Europe

“…The study was carried out in Constanta county, which was known for an HIV outbreak [ 16 ]. Young Roma men in Bulgaria ( n = 405) had an HIV prevalence of 0.5 per cent [ 20 ]. In Budapest, Hungary, however, neither of the two populations of Roma surveyed had HIV, despite one group being made up of injecting drug users (IDUs) [ 18 , 19 ].…”

“…A study of young Roma men in Sofia, Bulgaria ( n = 296) found that 21.7 per cent had at least one STD (trichomonas, chlamydia, gonorrhoea or syphilis) and that the rates of gonorrhoea and syphilis were 1807 and 312 times the national levels, respectively [ 17 ]. A later study by the same group of researchers examining a larger group of young Roma men found much lower rates of infection [ 20 ].…”

“…Notwithstanding the instances mentioned above, Roma have a higher occurrence of communicable diseases than non-Roma. The most common reasons hypothesised by authors for the higher rates of disease are lack of water, poor sanitation and hygiene, crowded living spaces, high-risk sexual behaviours, and exposure to animals and waste [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ].…”

“…In Sofia, for example, the prevalence of gonorrhoea and syphilis was many hundred times the national levels [ 17 ]. On the other hand, despite repeated studies describing high-risk sexual behaviour, the prevalence of STDs is sometimes not very high [ 20 , 23 ]. Amirkhanian et al hypothesize that this is probably due to the social insularity of the groups [ 20 ].…”