HIV risk behavior patterns, predictors, and sexually transmitted disease prevalence in the social networks of young Roma (Gypsy) men in Sofia, Bulgaria.

Objective: This research studied predictors of high-risk sexual practices and sexually transmitted disease (STD) prevalence among Roma (Gypsy) men's social networks in Sofia, Bulgaria.

Methods: Fifty-four socially active individuals, approached in Roma neighborhood venues, recruited members (n = 296) of their own networks into the study. Participants completed sociometric and risk behavior interviews and were tested for chlamydia, gonorrhea, syphilis, and trichomonas.

Results: Men had a mean of 7 partners in the past year. Fifty-nine percent had multiple partners in the past 3 months. Seventy-three percent reported recent unprotected vaginal and 51% unprotected anal intercourse. Fifty-nine percent of men had sex with other men in the past year. Twenty-two percent had one of the STDs. The social network to which an individual belonged accounted for 23% to 27% of variance in predicting sexual risk behavior.

Conclusions: One's social network was the most powerful predictor of HIV risk behavior. HIV/STD prevention interventions directed toward entire social networks are especially promising.