title: High rates of STD and sexual risk behaviors among Garífunas in Honduras.
abstract: BACKGROUND
  Honduras has the highest concentration of HIV and AIDS cases in Central America, with an estimated adult HIV prevalence of 1.5%. Prevalence is higher among certain ethnic groups such as the Garífuna with a reported HIV prevalence of 8%.
  
  
  METHODS
  A biological and behavioral survey was conducted on a stratified random sample of the Garífuna population in Honduras, using computer-assisted interviews. Blood was tested for HIV, herpes simplex type 2 (HSV-2), and syphilis; urine was tested for Chlamydia trachomatis, Neisseria gonorrhoea, Trichomonas vaginalis, and Mycoplasma genitalum.
  
  
  RESULTS
  We enrolled a total of 817 participants, 41% female and 51% male. Estimated prevalences and 95% confidence intervals (CI) were: HIV, 4.5% (95% CI: 3.0 to 6.6), HSV-2, 51.1% (95% CI: 46.7 to 55.6), and syphilis seropositivity, 2.4% (95% CI: 1.4 to 4.0). Sexually transmitted infections in urine were: chlamydia, 6.8% (95% CI: 4.7 to 9.7), gonorrhea, 1.1% (95% CI: 0.4 to 2.9), trichomoniasis, 10.5% (95% CI: 8.1 to 13.6), and Mycoplasma genitalium, 7.1% (95% CI: 5.1 to 9.9). Consistent condom use was low with stable (10.6%) and casual (41.4%) partners. In multivariate analysis, HIV was associated with rural residence. HSV-2 was associated with female sex, older age, and syphilis seropositivity.
  
  
  CONCLUSIONS
  We found a moderate prevalence of HIV and a high prevalence of HSV-2 among the Garífunas. HSV-2 may increase the vulnerability of these populations to HIV in the future. Intervention strategies should emphasize sexually transmitted infection control and condom promotion, specifically targeting the Garífuna population.
authors.affiliation: Global AIDS Program for Central America and Panama, University of Valle of Guatemala and Centers for Disease Control and Prevention Collaboration, Guatemala City, Guatemala. gpaz@gt.cdc.gov
authors.forename: Gabriela
authors.initials: G
authors.lastname: Paz-Bailey
authors.forename: Sonia
authors.initials: S
authors.lastname: Morales-Miranda
authors.forename: Jerry O
authors.initials: JO
authors.lastname: Jacobson
authors.forename: Sundeep K
authors.initials: SK
authors.lastname: Gupta
authors.forename: Keith
authors.initials: K
authors.lastname: Sabin
authors.forename: Suyapa
authors.initials: S
authors.lastname: Mendoza
authors.forename: Mayte
authors.initials: M
authors.lastname: Paredes
authors.forename: Berta
authors.initials: B
authors.lastname: Alvarez
authors.forename: Edgar
authors.initials: E
authors.lastname: Monterroso
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001769:Blood / Q000276:immunology / Q000821:virology; D005260:Female; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control; D014556:Urine / Q000382:microbiology / Q000469:parasitology; D055815:Young Adult