Male partner's risk behaviors associated with reactive HIV rapid tests among pregnant women in Mexico

Background: Mexican women acquire HIV almost exclusively through heterosexual contact (99%) and their vulnerability to infection may stem from the risk behaviors of their male partners. This study analyzed associations between pregnant women's reactivity to the rapid HIV antibody test and their report of their own and their male partners HIV risk behavior. Methods: Retrospective pseudo-experimental design of pregnant Mexican women completing a rapid HIV-test in the public health system between October 2006 and December 2009 (n=1514, 766 reactive women and 748 non-reactive controls who took a rapid HIV test at the same healthcare delivery site and were matched for age, fertility, and ethnicity). Bivariate analysis compared reactive and non-reactive women at 95% confidence level. Results: With the exception of multiple sexual partners during the past 12 months (p<0.003), there were no significant differences in risk behavior reported by reactive pregnant women compared with non-reactive controls. There were significant differences between reactive and non-reactive pregnant women's reports of their male partner's risk behavior: multiple sex partners (p<0.033); sex work (p<0.037); injection drug use (p<0.034); incarceration (p<0.037); and bisexual behavior (p<0.030). More than half of both groups of women stated that their male partner had multiple sexual partners. Conclusions: This study suggests the risk-behaviors of male partners contribute significantly to Mexican women's vulnerability to HIV-infection. Focused HIV-prevention for men who use drugs, are incarcerated, trade sex, or have sex with other men is needed. The ubiquity of suspected male sexual infidelity underlines the need for HIV-prevention education for married women.