Extrarelational Sex Places Primary Partners of Mexican Men at Risk for HIV and STDs, Study Says

Targeted HIV and STD prevention programs may be useful in preventing disease transmission among married and cohabiting Mexican couples, as women's "main risk" for HIV and other STDs is often dependent upon the sexual behavior of their male partners, and safe sex negotiation is frequently controlled by men, according to a study published in the October issue of the American Journal of Public Health. Julie Pulerwitz of the Population Council in Washington, D.C., and colleagues in Mexico and at the Harvard School of Public Health studied 3,990 sexually active married or cohabitating Mexican men to determine their frequency of extrarelational sex and their partners' risk of disease.

Findings
The researchers found that 15% of the men reported having extrarelational sex during the past year, with the number of extrarelational partners ranging from one to 30, and only 0.1% reporting same-sex sexual behavior. Five percent of the men noted that the extrarelational partner was a prostitute, but most men said they engaged in extrarelational sex with a "friend" (54%), "mistress" (17%), or "coworker" (14%). Nine percent of men who reported extrarelational sex said they used a condom during last intercourse -- 22% if their last intercourse was with a secondary partner and 4% if their last intercourse was with their primary partner. Among men who had sex with a secondary partner, more condom use was reported with friends (21%) and mistresses (17%) than with coworkers (10%). A higher level of education was associated with condom use with a primary partner, while a white-collar occupation was linked with condom use with a secondary partner. Men who had anal sex during their last sexual activity did not report using condoms. Of the men who had extrarelational sex, 80% perceived no personal HIV risk and 70% said they never placed another person at risk of contracting HIV or an STD. Eighty-nine percent of these men said their primary partners were unaware of the secondary partners, and 33% said their secondary partners were unaware of the primary partners.

Conclusions
The researchers said that the percentage of men who reported extrarelational sex in their sample size could reflect almost 250,000 married and cohabitating men in the Mexican population who have sex with secondary partners over one year. If 5% of these men are exposed to an STD, including HIV, and transmit it to their primary partners, more than 10,000 wives and cohabitating partners could be infected each year. The researchers concluded, "The combination of substantial amounts of extrarelational sex, minimal condom use, and lack of perceived HIV risk indicates that HIV and other STD prevention efforts that take into account the social context of these risky behaviors are required" (Pulerwitz et al., American Journal of Public Health, October 2001).