Multiple Heterosexual Partners and Condom Use Among Hispanics and Non-Hispanic Whites.

A telephone survey of 1,592 Hispanic and 629 non-Hispanic white men and women aged 18--49, randomly selected from nine states in the northeastern and southwestern United States, found that married Hispanic men are more likely to have had two or more heterosexual partners in the previous 12 months than are married non-Hispanic men (18% and 9%, respectively). A large proportion of unmarried men (60% of Hispanics and 54% of non-Hispanic whites) report having had more than one partner in the past 12 months. After adjusting for other variables, the odds of having multiple partners are 2.5 times higher among Hispanic men aged 18-24 than among those aged 41-49 and 1.8 times higher among those who live in the Northeast than among those in the Southwest. Highly acculturated Hispanic men are less likely to have multiple partners than are less acculturated men. Among Hispanic women, those who are moderately or highly acculturated are more likely to have multiple partners (odds ratios of 4.9 and 8.4, respectively) than a re less acculturated women. About half of men and women with multiple partners report always using condoms with secondary heterosexual partners.

Hispanics have higher rates of sexually] transmitted diseases (STDs), (1) including the human immunodeficiency virus (HIV) (2) and AIDS (3) than does the population in general. This group has been especially affected by the spread of these diseases. (4) AIDS is currently the sixth leading cause of death among Hispanic adults, but it is not among the top 10 causes of death among non-Hispanic whites. (5) Differences in AIDS case statistics and HIV prevalence have been noted in subgroups of Hispanics, with those living in the northeastern United States having higher rates than those in the Southwest. (6) Although these higher rates have been attributed to intravenous drug use, primarily among Puerto Ricans in the Northeast, (7) sexual behavior patterns could also contribute to these differences. Until now, no study has assessed possible regional differences among Hispanics regarding sexual behavior.

(Family Planning Perspectives, 25:170-174, 1993)

Data on the sexual behavior of Hispanics are limited, but anthropological research suggests that among this group there is often a double standard for the sexes, by which men are allowed or even expected to have multiple sexual partners. while women are not. (8) Surveys of Hispanic adults in San Francisco have confirmed this gender difference, (9) but how widespread the double standard is, and whether there are regional or subgroup differences among Hispanics, is unknown, as is to what extent these patterns of sexual behavior differ from those of mainstream non-Hispanic whites.

Little is known about condom use among Hispanics, especially men, since the majority of data come from family planning studies of married women. (10) These studies have found very low levels of condom use (less than 15%) among married women, both Hispanics and non-Hispanic whites, who were using a contraceptive method. Whether these low rates also apply to individuals with two or more sexual partners is not known. A study conducted in San Francisco found that Hispanic men with multiple partners were more likely to use condoms with a secondary partner than with a primary partner. (11) With rare exceptions, (12) studies about heterosexual condom use have not distinguished between use with a primary partner and use with secondary partners, despite the many differences in these relationships that could affect the motivation or ability to use condoms. This study was designed to assess the prevalence of multiple partners and of condom use with primary and secondary partners among Hispanics, compared with non-Hispan ic whites, and to determine if the sexual behavior of Hispanics in the Northeast differs from that of those in the Southwest.

Methodology

The survey was conducted by telephone; a modified two-stage Mitofsky-Waksberg sampling technique (13) was used to identify Hispanic households in nine states with Hispanic population concentrations ranging from 5% to 38% in the Northeast (New York, New Jersey, Massachusetts and Connecticut) and the Southwest (California, Arizona, Colorado, New Mexico and Texas). The Hispanic population in these states represents 77% of all U. S. Hispanics. (14) A random subset of non-Hispanic white respondents was also selected for interviewing at both stages of sampling. These individuals do not necessarily represent non-Hispanic whites in these nine states, but do represent non-Hispanic whites living in areas where Hispanics reside.