II. Multiple Sexual Partners Among Hispanics in High-Risk Cities. (Data from the National AIDS Behavioral Surveys).(Statistical Data Included)

Data from a random sample of 4,658 heterosexual Hispanics from 23 high-risk cities in the 1990-1991 National AIDS Behavioral Surveys reveal that 11% of Hispanics have had multiple partners in the past year--17% of men and 4% of women. The study shows a higher proportion of multiple sexual partners in the past year among Hispanic men who are unmarried (31%), Cuban (28%), aged 18-29(25%), better educated (21%), of lower income (23%) and highly acculturated (20%). Among Hispanic women, marital status, age, Hispanic subgroup and level of acculturation are significant predictors of having multiple partners. Among highly acculturated Hispanic men, income, Hispanic subgroup and marital status are significant predictors of having multiple partners; among less acculturated Hispanic men, marital status is the only significant predictor. Only 20% of Hispanics with multiple partners report using a condom regularly with their primary partner, and 29% report regular condom use with their secondary partner. Among men, condo m use tends to decrease as the number of partners increases.

(Family Planning Perspectives, 25: 257-262,1993)

Hispanics, the fastest growing minority in the United States, have been disproportionately affected by AIDS. Although they represent approximately 8% of the total U.S. population, Hispanics account for 16% of AIDS cases.(1) HIV prevalence is three times higher among Hispanics than among non-Hispanic whites. (2) In 1991, the incidence of AIDS among Hispanics in the United States was 32 per 100,000 population, compared with 12 per 100,000 among non-Hispanic whites; in 1989, the incidence of heterosexually acquired AIDS was 10 times as high among Hispanics as among non-Hispanic whites. (3) In 1990, mortality attributable to AIDS was 22 deaths per 100,000 among Hispanics, compared with 9 per 100,000 among non-Hispanic whites. (4) The proportion of Hispanic AIDS cases among children (21%) and women of childbearing age (17%) is also disproportionate to their representation in the U.S. population (11% and 8%, respectively). (5)

Hispanics also have a relatively high rate of other sexually transmitted diseases (STDs), including ulcerative STDs, which are cofactors for HIV infection. The incidence of syphilis, gonorrhea and cervical cancer is greater among Hispanics than among non-Hispanic whites. (6) Hispanic men are also more likely than non-Hispanic men to have multiple vaginal sex partners, to have same-gender sexual contacts, to have anal intercourse with multiple partners and to engage in high-risk sexual behavior. (7)

To understand the incidence of multiple sexual partners among Hispanics, cultural factors must be examined. Traditional Hispanic culture is characterized by a male-centered view in which men tend to prove their virility by having multiple sex partners. (8) The Hispanic notion of machismo may perpetuate traditional sex-role stereotypes and double standards. These traditional attitudes may result in a greater number of unprotected sexual contacts, and thus an increased risk of HIV infection among Hispanics.

Although most Hispanics share a common cultural heritage--the Spanish language, the Catholic religion, and cultural values, such as unity, reliance and the central role of the family--important differences exist among Hispanic subgroups. A large proportion of Mexican Americans, who make up 62% of the Hispanic population in the United States, live in the Southwest. They have the youngest median age (24 years) among Hispanic subgroups, a very high birthrate and large extended families that include godparents. (9) Puerto Ricans, who represent 13% of U.S. Hispanics, live in major northeastern urban areas and in Puerto Rico, are U.S. citizens, have the highest rate of female headed families and are the most economically disadvantaged Hispanic sub-group. (10) Cuban Americans (5% of U.S. Hispanics) live primarily in Florida, have higher educational levels and are less likely than other Hispanic subgroups to live below the poverty level. (11)

Studies of multiple sex partners among Hispanics are scarce, and specific Hispanic subgroups have not been examined. To plan effective HIV prevention programs, we need to know the prevalence of multiple partners across social strata, including the major U.S. Hispanic subgroups (Mexican, Puerto Rican and Cuban), acculturation levels (Spanish vs. English speakers) and gender. This article describes the demographic correlates of multiple sex partners among respondents in a randomly selected sample of heterosexual Hispanics from large cities and also examines the prevalence of condom use in this sample.