Belize has the highest rates of HIV infection in Central America and is experiencing a generalized epidemic. The Garífuna, a minority ethnic population, is at risk for HIV. This study uses survey data from Garífuna men and women to examine the frequency of multiple partnerships as well as sociodemographic characteristics and behavioral constructs correlated with having multiple partners. A high proportion of respondents reported having multiple partners, but rates were significantly higher for men, and men had a higher mean number of partners than women. A high proportion of respondents reported having a sexually transmitted infection (STI) in the last year, with more men reporting a history of STIs than women. Regression results show the importance of improving men and women’s perceived susceptibility for HIV and encouraging them to know their HIV status. Reinforcing a social norm for partner reduction would also benefit men. Study findings support the need for HIV counseling and testing in Garífuna communities as well as STI prevention, diagnosis and treatment. This study demonstrates that reducing multiple partnerships among Garífuna men and women is critical for reducing the spread of HIV in Belize.
UNGASS (2010) UNGASS country progress report: Belize. http://www.unaids.org/en/dataanalysis/monitoringcountryprogress/2010progressreportssubmprogressreportss/belize _2010_country_progress_report_en.pdf
WHO (2011) Global health observatory data repository. http://apps.who.int/ghodata/
Matthei, L.M. and Smith, D.A. (2008) Flexible ethnic identity, adaptation, survival, resistance: The Garífuna in the world system. Social Identities, 14, 215-232. doi:10.1080/13504630801933290
Statistical Institute of Belize (2011) Main results of 2010 population and housing census. http://www.statisticsbelize.org.bz/dms20uc/dynamicdata/docs/20110505004542_2.pdf
Kishamwe, C., Vissers, D., Urassa M., Isingo, R., Mwaluko, G., Borsboom, G., Voeten, H., Zaba, B., Habbema, J. and de Vlas, S. (2006) Mobility and HIV in tanzanian couples: Both mobile persons and their partners show increased risk. AIDS, 20, 601-608. doi:10.1097/01.aids.0000210615.83330.b2
Vissers, D., Voeten H., Urassa, M., Isingo, R., Ndege, M., Kumogola, Y., Mwaluko, G., Zaba, B., de Vlas, S. and Habbema, J. (2008) Separation of spouses due to travel and living apart raises HIV risk in Tanzanian couples. Sexually Transmitted Diseases, 35, 714-720. doi:10.1097/OLQ.0b013e3181723d93
Stansbury, J.P. and Sierra, M. (2004) Risks, stigma and Honduran Garífuna conceptions of HIV/AIDS. Social Science & Medicine, 59, 457-471. doi:10.1016/j.socscimed.2003.11.013
Kerns, V. (1992) Female control of sexuality: Garífuna women at middle age. In: Kerns, V. and Brown, J., Eds., In Her Prime: New Views of Middle-Aged Women, University of Illinois Press, Champaign, 95-112.
PAHO (2001) HIV and AIDS in the Americas: An epidemic with many faces. http://www.paho.org/English/HCP/HCA/faces_final.pdf
Garc?a, J.M., Salavarr?a, N., Valent?n, D., Ramirez, D. and Sierra, M. (2000) Proyecto “educación preventiva y fortalecimiento de la respuesta local en las comunidades garífunas.” Aspectos Sociodemográficos, Conocimientos, Creencias, Actitudes y Prácticas Relacionadas con la Transmisión de ITS/VIH en las Comunidades Garífunas. Tegucigalpa, Honduras. MDC: Asociación El Buen Pastor; Organización Panamericana de la Salúd/ONUSIDA, Departamentos de ETS/SIDA/TB, Secretaria de Salúd.
UNAIDS (2010) Honduras: HIV/AIDS health profile. http://www.usaid.gov/our_work/global_health/aids/Countries/lac/honduras.pdf
Adimora, A.A., Schoenbach, V.J. and Bonas, D.M. (2002) Concurrent sexual partnerships among women in the United States. Epidemiology, 13, 320-327. doi:10.1097/00001648-200205000-00013
Morris, M. (2008) The relationship between concurrent partnerships and HIV transmission. Presentation to the PEPFAR General Population and Youth HIV Prevention, Technical Working Group and AIDSTAR-One Project, 29-30 October, Washington, DC.
Castor, D., Jolly, P. and Furlonge, C. (2002) Determinants of gonorrhea infection among STI clinic attenders in Trinidad—II: Sexual behavioral factors. International Journal of STD/AIDS, 13, 46-51. doi:10.1258/0956462021924479
Potterat, J., Zimmerman-Rogers, H. and Muth, S. (1999) Chlamydia transmission: Concurrency, reproduction number, and the epidemic trajectory. American Journal of Epidemiology, 150, 1331-1339. doi:10.1093/oxfordjournals.aje.a009965
Rosenberg, G.J., Gurvey, J.E. and Adler, N. (1999) Concurrent sex partners and risk for sexually transmitted diseases among adolescents. Sexually Transmitted Diseases, 26, 208-212. doi:10.1097/00007435-199904000-00004
Drumright, L.N., Gorbach, P.M. and Holmes, K.K. (2004) Do people really know their sex partners? Concurrency, knowledge of partner behavior, and sexually transmitted infections within partnerships. Sexually Transmitted Diseases, 31, 437-442. doi:10.1097/01.OLQ.0000129949.30114.37
Rothschild, M. (1999) Carrots, sticks, and promises: A conceptual framework for the management of public health and social issue behaviors. Journal of Marketing, 63, 24-37. doi:10.2307/1251972
Rosenstock, I.M. (1974) Historical origins of the health belief model. Health Education Monographs, 2, 328-335.
Fishbein, M. and Azjen, I. (1975) Belief, Attitude, intention, and behavior. Addison-Wesley, Boston.
Chapman, S. (2004) Evaluating social marketing interventions. In: Thorogood, M. and Coombes, Y., Eds., Evaluating Health Promotion, Oxford University Press, Oxford, 93-110. doi:10.1093/acprof:oso/9780198528807.003.0007
Scott-Wright, A., Hakre, S., Bryan, J.P., Jaramillo, R., Reyes, L.G., Cruess, D., Macarthy, P.O. and Gaydos, J.C. (1997) Hepatitis B virus, human immunodeficiency virus type-1, and syphilis among women attending prenatal clinics in Belize, Central America. American Journal of Tropical Medicine & Hygiene, 56, 285-290.
Senn, T.E., Scott-Sheldon, L.A., Seward, D.X., Wright, E.M. and Carey, M.P. (2011) Sexual partner concurrency of urban male and female STD clinic patients: A qualitative study. Archives of Sexual Behavior, 40, 775-784. doi:10.1007/s10508-010-9688-y
Joshi, A. (2010) Multiple sexual partners: Perceptions of young men in Uganda. Journal of Health Organization and Management, 24, 520-527.
Mavhu, W., Langhaug, L., Pascoe, S., Dirawo, J., Hart, G. and Cowan, F. (2011) A novel tool to assess community norms and attitudes to multiple and concurrent sexual partnering in rural Zimbabwe: Participatory attitudinal ranking. AIDS Care, 23, 52-59. doi:10.1080/09540121.2010.490257
Bingenheimer, J.B. (2010) Men’s multiple sexual partnerships in 15 Sub-Saharan African countries: Sociodemographic patterns and implications. Studies in Family Planning, 41, 1-17. doi:10.1111/j.1728-4465.2010.00220.x