Estimating HIV prevalence and risk behaviors among high-risk heterosexual men with multiple sex partners: use of respondent-driven sampling.

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.