XVIII International AIDS Conference


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Child sexual abuse, incest and HIV: the perspective of service providers in Trinidad and Tobago

S.D. Reid1, R. Reddock2, T. Rogers2, T. Nickenig2

1University of the West Indies, Department of Clinical Medical Sciences, St. Augustine, Trinidad and Tobago, 2University of the West Indies, St. Augustine, Trinidad and Tobago

Background: Despite increasing media reports in Trinidad and Tobago, there is a paucity of research on child sexual abuse (CSA) and incest. CSA/incest is an egregious violation of children's rights that increases HIV risk directly, and indirectly through associated adult psychopathology. This paper targeted service providers who are regularly in contact with potential victims. It gathered data on knowledge, attitudes and gender sensitivity to CSA/incest, perceptions of context and prevalence, workplace policies and procedures, and awareness of the relationship between CSA/incest and HIV infection. Data was used to assess the capacity of service providers to identify and treat with CSA/incest, the impact of personal beliefs on practice and the appropriateness of responses especially as it relates to HIV prevention and treatment.
Methods: Using semi-structured interviews, quantitative and qualitative data were collected from a purposive sample of 68 service providers in social, health and legal services in Trinidad and Tobago.
Results: Service providers reported an increasing prevalence of cases of CSA/incest despite continued resistance to reporting. Services were not considered to be child-sensitive; legal and institutional infrastructures were deficient and compromised the safety of victims. Most service providers had received HIV but not gender sensitization, but the intersection between CSA/incest and HIV services was inadequate. The conceptualizations and meanings of CSA/incest varied significantly and were major determinants in the formulation of services. Personal attitudes to CSA/incest reflected societal myths, stigmatization and gender biases.
Conclusions: This study began an understanding of the meaning of CSA/incest in Trinidad and Tobago. It establishes CSA/incest as increasingly prevalent but inadequately managed. Findings point to areas that need to be addressed to improve the management of CSA/incest. This will be facilitated by the increased sensitization to the relationship between CSA/incest and HIV and the new discourse that has been established between researchers and service providers.

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