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Estimating HIV Prevalence and Risk Behaviors Among High-Risk Heterosexual Men With Multiple Sex Partners: Use of Respondent-Driven Sampling

Chopra, Mickey MSc*; Townsend, Loraine MSc*; Johnston, Lisa PhD; Mathews, Cathy PhD*‡; Tomlinson, Mark PhD*‖; O'Bra, Heidi MPH§; Kendall, Carl PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes: May 2009 - Volume 51 - Issue 1 - p 72-77
doi: 10.1097/QAI.0b013e31819907de
Epidemiology and Social Science

Objectives: To collect HIV data from high-risk men who have multiple, younger, female sex partners in a periurban township in South Africa.

Design: Unlinked anonymous cross-sectional survey using respondent-driven sampling.

Methods: Survey conducted among men aged 18 years or older who reported having had sex with more than 1 female partner in the previous 3 months (one of whom was either 3 or more years younger than the participant or below the age of 24) and lived in the area of recruitment.

Results: The median age of the 421 recruited men was 28 years (range: 18-62 years). They reported a median of 6 sexual partners (range: 2-39) during the past 3 months, and 51% (confidence interval: 45.0 to 59.6) reported inconsistent condom use with their casual partners. During the 3 months before the survey, 98% of men reported having concurrent sexual relationships. HIV prevalence was 12.3% (confidence interval: 8.3% to 16.9%). Being older than 24 years and not using a condom during the last sexual intercourse with a 1-time sexual partner were significantly associated with HIV infection.

Conclusions: This group of heterosexual urban men practice high levels of risky sexual behavior and are an important group that require more targeted HIV surveillance and prevention interventions.

From the *Health Systems Research Unit, Medical Research Council, Cape Town, South Africa; †Department of International Health and Development, Tulane University, School of Public Health and Tropical Medicine, Center for Global Health Equity, New Orleans, LA; ‡School of Public Health and Family Medicine, University of Cape Town, Rondebosch, South Africa; §HHS-Centers for Disease Control and Prevention/Global AIDS Program, Pretoria, South Africa; and ‖Department of Psychology, University of Stellenbosch, South Africa.

Received for publication September 23, 2008; accepted December 12, 2008.

Supported by fund from the Medical Research Council, South Africa, and the US Centers for Disease Control and Prevention/Global AIDS Program, Pretoria, South Africa.

Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent those of the Centers for Disease Control and Prevention.

Correspondence to: Prof Mickey Chopra, MSc, Health Systems Research Unit, Medical Research Council, Parow, 7505 Western Cape, South Africa (e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.