Evidence on Delay in Sexual Initiation, Multiple Partnerships and Condom Use among Young People: Review of Caribbean HIV Behavioural Studies

Objective: To develop a Caribbean regional profile of youth sexual behaviour associated with risk of HIV. Design and methods: A review or sexual behaviour surveys with youth aged 15-24 years was conducted as part of the Pan American Health Organization (PAHO) HIV Caribbean Office's Review and Gender Analysis of Caribbean HIV Behavioural and Seroprevalence Studies. Studies with internationally recommended indicators were prioritized. Studies were sought via database searches and contact with researchers and National AIDS Programmes. Results: Inter-country comparisons and longitudinal analyses were limited by lack of uniformity in study age groups and indicators. Data were sufficient to identify the following among 15-24-year olds: More males than females report sexual intercourse before the age of 15 years. More than half of sexually active youth report sex before age 16 years. First sexual encounter is usually with someone older with age differences larger for females. More males than females report multiple partnerships, with 20%-76% of males reporting this in the past year. Condom use varies widely, with no clear pattern by gender Conclusion: There are substantial levels of early sexual initiation, intergenerational sex among females and multiple partnerships among males, while condom use is inconsistent. Efforts to promote delay in sexual initiation, partner reduction and consistent condom use should be supplemented with initiatives against harmful gender norms, child abuse and transactional sex and skills to negotiate safe sex. Standardization of survey methods to facilitate cross-study comparisons should continue and encompass additional risk factors such as transactional sex, gender-based violence, drug use and HIV treatment adherence.