HIV-Related Sexual Risk Behaviors Among the Miskito Population in Honduras: Associations With Residence, Sex, and Partnerships in a Cross-Sectional Study.

IntroductionHuman Immunodeficiency Virus (HIV) remains a public health issue, particularly among vulnerable populations. Indigenous communities, such as the Miskito people in Honduras, face social and structural inequalities that can influence sexual behaviors and thereby increase the risk of infection. With this study we propose to analyze the factors associated with risky sexual behaviors for HIV acquisition among the Miskito population.MethodsA cross-sectional study selected through multistage random quota sampling; in the multivariable generalized linear model using modified Poisson regression with a log link and robust variance, data collection instruments were translated into the Miskito language, and the study protocol was reviewed and approved by the Institutional Ethics Committee. Written informed consent was obtained from all participants prior to enrollment.Results869 completed the survey, 59.8% were women, 60.3% lived in an urban area. Additionally, 98.0% identified as heterosexual, and 62.8% did not have a stable sexual partner. In the multivariable generalized linear model (Poisson family, log link function, and robust variance), HIV-related sexual risk behaviors were more prevalent among men (aPR: 1.94; 95% CI: 1.55-2.43), individuals living in urban areas (aPR: 1.92; 95% CI: 1.44-2.56), those identifying as LGBTQI+ (aPR: 1.49; 95% CI: 1.02-2.17), and those reporting a greater number of sexual partners in the past six months (aPR: 1.03; 95% CI: 1.01-1.05).ConclusionThese results underscore the need for culturally sensitive prevention, inclusive sex education, and differentiated service delivery tailored to the Miskito population.