HIV-1 seropositivity and behavioral and sociological risks among homosexual and bisexual men in six Mexican cities.

We report on the epidemiology of sexual behaviors, HIV-1 seroprevalence, and condom use in gay and bisexual men in six Mexican cities in 1988 and test the extent to which variations in sexual behavior and sociological risks are responsible for variations in prevalence. Seroprevalence rates among samples in six cities ranged from 2% to 25%. In multiple logistic regression models controlling for city, insertive/receptive behavior (IRB), and meeting partners in bathhouses, the following were independently related to seropositivity (p less than 0.05): city, IRB, syphilis, sex with a person with AIDS, and meeting partners in bathouses. The independent risks associated with categories of IRB were no or almost no activity (odds ratio 1.0), only insertive (3.0), mostly insertive (4.9), mixed (6.0), mostly receptive (3.3), and only receptive (0.9). The condom use rate on last sexual encounter was 30%. The main sexual risk for HIV-1 infection is not exclusively receptive anal sex, but rather mixed behavior. This association may be explained by the infectious state of the partner pools. The sociologic risk variables (national and local partner pools) are better predictors of seroprevalence than behavioral variables, such as the number of partners or use of condoms. These results imply that more effective individual strategies for risk reduction are needed, including better knowledge concerning the risk status of partners.