Consistent condom use among youth in Tobago: baseline findings to inform an HIV prevention intervention
C. Barrington1, B. Nieto-Andrade2, J. Joseph3, A. Rampersad3, J. Roberts3, O. Adeniyi3
1University of North Carolina at Chapel Hill Gillings School of Global Public Health, Department of Health Behavior & Health Education, Chapel Hill, United States, 2Population Services International, Guatemala City, Guatemala, 3PSI-Trinidad and Tobago, Port of Spain, Trinidad and Tobago
Background: Young women are disproportionately affected by HIV/AIDS in Trinidad and Tobago. Recent studies suggest that HIV infections are six times higher among 15-19 year-old females compared to males. PSI/Caribbean and the Society for Family Health (SFH) are implementing a World Bank-funded HIV prevention program in Tobago to address this disparity by promoting condom use among sexually active young men and women through peer education and mass media.
Methods: Sexually active youth (n=407) (16-26 years) were recruited using time location sampling to participate in a baseline behavioral survey to identify determinants of condom use in 2009. Variables included demographics, sexual behaviors, and behavioral determinants of condom use. Consistent condom use (CCU) was defined as using condoms in every sex act out of all sex acts with regular, casual and commercial partners in the last month. Multivariate logistic regression was used to identify the most significant independent variables associated with CCU. Analysis of variance was used to estimate the adjusted means/proportions of each explanatory variable by CCU.
Results: Only 9.3% of participants reported CCU with all partners in the last month, while 32.5% reported using a condom at last sex. Significant predictors of CCU included: 1) having fewer regular partners in the last month (p< 0.01); 2) carrying a condom at the time of the interview (p< 0.001); 3) not feeling embarrassed to ask partners to use condoms (p< 0.05); 4) intending to use condoms consistently with all types of partners (p< 0.01).
Conclusions: Condom use is not widely practiced among sexually active youth in Tobago and findings highlight the discrepancy between measures of “consistent” and “last sex” condom use. Future efforts should improve understanding of partnership and power dynamics to develop effective strategies for promoting consistent condom use among youth in all types of relationships, in particular regular partnerships characterized by trust and intimacy.
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