OBJECTIVES:
To
describe levels of risky sexual behaviour, HIV testing and HIV knowledge among
men and women in Guatemala by ethnic group and to identify adjusted
associations between ethnicity and these outcomes.
DESIGN:
Data on
16,205 women aged 15-49 and 6822 men aged 15-59 from the 2008-2009 Encuesta
Nacional de Salud Materno Infantil were used to describe ethnic group
differences in sexual behaviour, HIV knowledge and testing. We then controlled
for age, education, wealth and other socio-demographic factors in a multivariate
logistic regression model to examine the effects of ethnicity on outcomes
related to age at sexual debut, number of lifetime sex partners, comprehensive
HIV knowledge, HIV testing and lifetime sex worker patronage (men only).
RESULTS:
The data
show low levels of risky sexual behaviour and low levels of HIV knowledge among
indigenous women and men, compared to other respondents. Controlling for
demographic factors, indigenous women were more likely than other women never
to have been tested for HIV and to lack comprehensive HIV knowledge. They were
less likely to report early sexual debut and three or more lifetime sexual
partners. Indigenous men were more likely than other men to lack comprehensive
HIV knowledge and demonstrated lower odds of early sexual debut, 10 or more
lifetime sexual partners and sex worker patronage.
CONCLUSIONS:
The
Mayan indigenous population in Guatemala, while broadly socially vulnerable,
does not appear to be at elevated risk for HIV based on this analysis of
selected risk factors. Nonetheless, low rates of HIV knowledge and testing may
be cause for concern. Programmes working in indigenous communities should focus
on HIV education and reducing barriers to testing. Further research into the
factors that underlie ethnic self-identity and perceived ethnicity could help
clarify the relative significance of these measures for HIV risk and other
health outcomes.
1 Global Health Systems and Development , Tulane
University , New Orleans , LA , USA.
Ethn Health. 2015;20(2):163-77. doi: 10.1080/13557858.2014.893562. Epub 2014 May 16.
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