Abstract

Psycosocial and behavioural predictors and prevalence of HIV testing behaviours among youth in three high prevalence Caribbean countries

B. Andrews

University of Southampton, Southampton, United Kingdom

Background: HIV/ AIDS is the leading cause of death among young adults in the Caribbean and only about one-third of the youth living with HIV are aware of their status yet little is known about their HIV testing behaviours. This study describes the patterns of and examines the factors associated with HIV testing among sexually experienced Caribbean youth in countries: Guyana, Dominican Republic and Haiti.
Methods: Using nationally representative surveys, subsamples of sexually experienced young adults aged 15 to 24 years were selected as follows: 875 in Guyana; 12,418 in Dominican Republic and 4,199 in Haiti. The outcome was ever tested for HIV/AIDS and independent factors examined were: socio-demographic control factors, risk behaviours, exposure to media and psychosocial variables. Bivariate and multivariable logistic regression analyses were used which accounted for the multistage complex design of the survey.
Results: The proportion of youth ever tested was 48% in Dominican Republic, 37% in Guyana and 17% in Haiti. In each country males were consistently less likely to test than females. Of those who tested, client initiated testing was highest in Haiti (54%), 42% in Guyana and 32% in Dominican Republic. In each country, currently married, formerly married youth, youth with larger number of lifetime partners, who had their sexual debut at an older age and who knew someone who had or died from HIV, had increased odds of testing than others. Rural youth in Haiti and Guyana were less likely to test than urban youth.
Conclusions: Low proportions of sexually active Caribbean youth had ever tested and were unaware of their HIV status. The needs of specific categories of youth such as males, unmarried, youth holding stigma attitudes and rural residents should be considered when designing interventions to improve HIV testing uptake. Policy implications are discussed.

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