Few studies of sexual behavior are available for Central America. The practice of commercial sex and sex outside marriage clearly exists but little is known about partner concurrency. Sub-type B is most common in the region but the significance of this fact for the future of the epidemic is unclear. Circumcision is not routinely practiced in the region so any protective effect would not be a factor. The prevalence of other STDs is high in some areas although there may be a decline in classical STDs and an increase in relatively new types, such as chlamydia.
Economic conditions are much better in Central America than in Africa.
Although the region has been plagued with civil wars this is now decreasing as a disruptive factor. General health conditions are good in Central America compared to Africa. During the discussion of the application of this information to the Central American context it was noted that several other factors may also be important. Plasma donations to commercial blood banks may have been an enhancing factor early in the epidemic in some regions since plasma donation can be made more frequently than donations of whole blood. This factor is likely to be less important today.