title: Gender roles and HIV sexual risk vulnerability of Roma (Gypsies) men and women in Bulgaria and Hungary: an ethnographic study.
abstract: Roma, the largest ethnic minority group in Central and Eastern Europe, have cultures that are traditional, often closed, and autonomous of majority populations. Roma communities are characterized by pervasive social health problems, widespread poverty, limited educational opportunities, and discrimination. Although some evidence suggests high levels of HIV sexual risk behaviour among Roma, little is known about the cultural and social context in which risk behaviour occurs. In-depth interviews were used to elicit detailed information about types of sexual partnerships and sexual risk behaviour practices occurring in them, use and perception of protection, knowledge and beliefs about AIDS and STDs, and sexual communication patterns in a sample of 42 men and women aged 18-52 living in Roma community settlements in Bulgaria and Hungary. Analysis of the interview data revealed that men have great sexual freedom before and during marriage, engage in a wide range of unprotected practices with primary and multiple outside partners, and have much more relationship power and control. In contrast, women are expected to maintain virginity before marriage and then sexual exclusivity to their husbands. Condom use is not normative and is mainly perceived as a form of contraception. Although awareness of AIDS was common, it was generally not perceived as a personal threat. Misconceptions about how HIV is transmitted are widespread, and women - in particular - had very little knowledge about STDs, HIV transmission, and protective steps. There is an urgent need for the development of HIV prevention programs culturally sensitive to Roma populations in Eastern Europe, where HIV rates are rapidly rising.
authors.affiliation: Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, 53202, USA. kdemming@mcw.edu.
authors.forename: J A
authors.initials: JA
authors.lastname: Kelly
authors.forename: Y A
authors.initials: YA
authors.lastname: Amirkhanian
authors.forename: E
authors.initials: E
authors.lastname: Kabakchieva
authors.forename: P
authors.initials: P
authors.lastname: Csepe
authors.forename: D W
authors.initials: DW
authors.lastname: Seal
authors.forename: R
authors.initials: R
authors.lastname: Antonova
authors.forename: A
authors.initials: A
authors.lastname: Mihaylov
authors.forename: G
authors.initials: G
authors.lastname: Gyukits
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health / Q000208:ethnology; D002031:Bulgaria / Q000453:epidemiology; D015331:Cohort Studies; D003469:Culture; D005260:Female; D005783:Gender Identity; D015658:HIV Infections / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D006178:Romani People / Q000208:ethnology / Q000523:psychology*; D012725:Sexual Behavior / Q000523:psychology*