J.A. Kelly and colleagues at the Medical College of Wisconsin studied Roma to understand the cultural and social context in which HIV sexual risk behavior among Roma occurs. "Roma, the largest ethnic minority group in Central and Eastern Europe, have cultures that are traditional, often closed, and autonomous of majority populations." "Roma communities are characterized by pervasive social health problems, widespread poverty, limited educational opportunities, and discrimination," the scientists explained.

In their study, "in-depth interviews were used to elicit detailed information about types of sexual partnerships and sexual risk behavior practices occurring in them, use and perception of protection, knowledge and beliefs about AIDS and STDs, and sexual communication patterns in a sample of 42 men and women aged 18-52 living in Roma community settlements in Bulgaria and Hungary."

According to study results, "Analysis of the interview data revealed that men have great sexual freedom before and during marriage, engage in a wide range of unprotected practices with primary and multiple outside partners, and have much more relationship power and control. In contrast, women are expected to maintain virginity before marriage and then sexual exclusivity to their husbands." The authors noted that condom use was not normative and was typically associated as a form of contraception. AIDS awareness was common, but AIDS was generally not perceived as a personal threat.

The researchers concluded, "Misconceptions about how HIV is transmitted are widespread, and women -- in particular -- had very little knowledge about STDs, HIV transmission, and protective steps. There is an urgent need for the development of HIV prevention programs culturally sensitive to Roma populations in Eastern Europe, where HIV rates are rapidly rising."

The study, "Gender Roles and HIV Sexual Risk Vulnerability of Roma (Gypsies) Men and Women in Bulgaria and Hungary: An Ethnographic Study," was published in AIDS Care (2004;16(2):231-246).

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