Male Youth on the Block (MYOB) in Saint Vincent, Caribbean: risks to HIV and condom use determinants
B. Nieto-Andrade1, J. Joseph2, K. Singh2, P. Faura3, A. Rampersad2
1Population Services International, Guatemala, Guatemala, 2Population Serivces International (Society for Family Health), Port of Spain, Trinidad and Tobago, 3Population Services International, Mexico, Mexico
Background: National HIV-prevalence in Saint Vincent is 0.4%, with no existing data for subpopulations. Literature suggests that young and poor men gathering on the streets (MYOB) are among the most at risk populations (UNGASS, 2008).
Methods: In order to identify priority risk factors and determinants of condom use as part of an intervention targeting MYOB, PSI conducted a quantitative study among 281 sexually active MYOB aged 16-26 in 2008. Study participants were identified using time-location sampling. Participants were also instructed to demonstrate the correct way to put on a condom using a wooden dildo. Frequencies to determine the level of indicators and logistic regression to identify condom use determinants at last sex with occasional partner were carried out.
Results: Among MYOB the average reported age for sexual debut was 13 years. The average number of sexual partners over the past month was 2.8, 1.7 of which was casual partner. 81% of sexually active males indicated using a condom at last sex with a casual partner. This dropped to 70.0% when measured over the last six months. Despite their reported sexual activity and condom use, only 9% of respondents could demonstrate a condom properly. The most frequently observed inaccuracies were not checking for expiration date (54.5%), not unrolling condom to base while keeping end pinched (36.5%) and not looking for opening notch on the package (64.0%).Among determinants of condom use, social support from friends to wear condoms (OR:3.3, p< 0.001) was most important; followed by self-efficacy to insist on condom use (OR:2.8, p< 0.001); positive attitudes towards condom reliability (OR:2.0, p< 0.001); and capacity to propose condom use with casual partners (OR:1.6, p< 0.05).
Conclusions: These results call for strategies that combine HIV-prevention with condom skills building. The findings also reinforce the importance of social support among friends and self-efficacy to increase consistent condom use.
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