Prevalence of same‐gender sexual behavior and HIV in a probability household survey in Mexican men

The prevalence of male same-gender sexual behavior in Mexico City in relation to HIV transmission was studied. A household probability survey of 8,068 adult men was conducted in 1992-93 using the Mexican National Health Survey sampling frame. The response rate was 59%. Differences between respondents and nonrespondents indicated no evidence for significant bias. A random subsample of 1,116 individuals provided serum or saliva for HIV testing. An estimated 2.5% of men practiced same-gender sex in their lifetime: 2.1% (95% CI: 1.7 - 2.4%) reported bisexual behavior and 0.4% (95% CI: 0.3 - 0.6%) reported exclusively homosexual behavior Among bisexuals, 70% reported sex only with women in the previous year, 7% reported sex only with men, 13% reported sex with both, and 10% were sexually inactive. A condom was used by 46% in their last homosexual encounter An estimated 0.1% of married men were homosexually active in the previous year The HIV prevalence estimate was 0.2% in the sample. The rate was 4% among homosexual/bisexual men and 0.09% in heterosexual men (p < 0.0001). Estimates of homosexual behavior and HIV infection from this population-based sample are lower than results from nonprobability studies. The low prevalence of condom use anticipates future growth of the epidemic in the homosexual population. Bisexual behavior appeared to be infrequent and transitory, particularly among married men. For more than a decade the impact of the human immunodeficiency virus (HIV) infection has been felt in many countries. Mexico is not an exception, and AIDS is among the leading causes of death in the young adult population. The fact that HIV is mainly transmitted by sexual activity makes it imperative that we have a better understanding of sexual behavior, in order to be able to favorably influence the trend of the epidemic. Case reports suggest that the epidemiological pattern of AIDS in Latin America is different from that observed in other parts of the world. Within this region, Mexico seems to have unique characteristics (Mann, Tarantola, & Netter, 1992; Valdespino, Izazola, & Rico, 1988); 95% of the cases to date among men and 45% among women are due to sexual transmission. Among men with sexually acquired AIDS, 60% were classified as homosexuals, 25% as bisexuals, and 15% as heterosexuals. HIV transmission due to injection drug use is negligible in Mexico (< 1% of reported cases). As of December 31, 1994, 20,796 AIDS cases had been reported in Mexico, most of which have occurred in men (85%), and in Mexico City (56%) (Instituto Nacional de Diagnostico y Referencia Epidemiologicos [INDRE], 1995).