Condom use and exposure to PSI/SFH's HIV prevention intervention among young women with concurrent transactional partners in Trinidad
C. Barrington1, B. Nieto-Andrade2, J. Joseph3, A. Rampersad3, P. Faura4, S. McDonald3
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, 4PSI-Mexico, Mexico City, Mexico
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. Concurrent transactional relationships are an important driver of the epidemic. In response, PSI-Caribbean/Society for Family Health (SFH) initiated a World Bank-funded HIV prevention program in Trinidad in 2008 to promote condom use among young women with concurrent transactional partners using peer education and mass media.
Methods: In February 2008, 121 young women (16 to 24) with concurrent transactional partners were recruited for a survey to identify determinants of condom use using respondent driven sampling. Measures included demographics, sexual behaviors, behavioral determinants, and exposure to PSI/SFH activities. Multivariate logistic regression was used to identify the most significant independent variables associated with condom use at last sex with a transactional partner. Analysis of variance was used to estimate the adjusted means/proportions of each explanatory variable by condom use.
Results: Condom use at last sex was lowest with regular partners (46.7%) and higher with casual partners (78.7%) and transactional partners (77.3%). The majority of young women (68.3%) had participated in a PSI/SFH activity in the last 6 months. Condom use at last sex with a transactional partner was significantly associated with: perceiving that condoms were easy to get (p< 0.05); considering it easy to always have a condom (p< 0.05); intending to use condoms with all partners (p< 0.01); participating in a PSI/SFH educational activity including a hands-on practice with condoms (p< 0.01).
Conclusions: Findings suggest that key determinants of condom use with transactional partners include availability and participation in hands-on activities. Future studies should examine individual, relational and structural barriers to condom use with regular partners and develop culturally appropriate strategies to promote condom use with all partners to further reduce HIV vulnerability among young women.
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