The Sexual Health Needs of Youth in Tobago: The Sexual Health Needs of Youth in Tobago Paper presented at the Centre for Caribbean Medicine Conference, St. Thomas Hospital, London, 6-7 July 2000 Caroline Allen, Keston McLetchie, Anne-Marie De Gazon Washington and Tristan Chapman-Smith


The Sexual Health Needs of Youth in Tobago: The Sexual Health Needs of Youth in Tobago Sponsored by: The Royal Netherlands Embassy, Trinidad and Tobago With technical support from: Caribbean Epidemiology Centre (CAREC) and the German Technical Cooperation Agency (GTZ)


Youth and HIV in Trinidad and Tobago: Youth and HIV in Trinidad and Tobago The Caribbean has the second highest HIV prevalence rates in the world (1.9%) A cord blood survey in Tobago showed rates of HIV infection of 3.5% in 14-19 year olds and 3.6% in 20-24 year olds In Trinidad and Tobago, the number of new cases of HIV has doubled every 3 to 4 years HIV/ AIDS is projected to cost 4.2% of GDP in the next ten years In the 15-19 year age group, there are SIX (6) times as many infected females as males


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Research questions: Research questions What are the features of Tobago youth sexual behaviour? How are they associated with socio-demographic characteristics, knowledge and attitudes? What are the implications for youth sexual health promotion strategies?


Methods: Methods 676 people aged 10-29 responded to a structured questionnaire survey (of which 3 were over 24) 44% male, 56% female 32.5% out-of-school 31.8% 10-14 year olds in-school 32.5% 15-19 year olds in school


Methods: Methods 12 focus groups with young people age 10-24 6 male focus groups, 6 female 4 out-of-school age 15-24, 4 in-school age 15-19, 4 in-school age 10-14 Out-of-school focus groups conducted in one rural and one urban village Schools selected for urban/ rural spread and type of school (secondary/ post-primary)


Tobago survey results : Tobago survey results Percentages who have ever had sex, by gender and sub-sample 14 73 86 12 40 55 0 10 20 30 40 50 60 70 80 90 100 10-14 in-school 15-19 in-school Out-of-school % Male Female


Age at first sex: Age at first sex Of the 46% of respondents who had sex: Average age at first sex was 14 Half had sex by the age of 15 A quarter had sex by the age of 12 6.5% (1 in 15) had their first sexual experience before the age of 10 Three-quarters had sex by the age of 16 Average age at first sex was 15 for girls and 13 for boys


Slide10: Frequency of age at first sex, by gender 0 5 10 15 20 25 30 35 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Age Frequency Male Female


Having sex the first time: Having sex the first time The partners of males were on average 1 year older than they were The average age of partners of males was 14 The partners of females were on average 4 years older than they were The average age of partners of females was 19


Number of sex partners in lifetime: Number of sex partners in lifetime 'How many people have you had sex with in your life?' by gender 0 10 20 30 40 50 60 1 2 to 4 5 to 9 10 to 20 andgt;20 Can’t remember Male Female Total %


Slide13: How can we explain behaviour? Quality of care No one to talk to - need counselling or guidance services Lack of confidentiality among health care workers Some workers do not respect young peoples’ right to choose Difficult to get condoms


Slide14: How can we explain behaviour? Culture of silence People have sex but do not talk about it Lack of communication between males and females Lack of communication between parents and children Religious leaders will not discuss sex Adults often condemn and criticise without understanding People 'bad talk' each other


Slide15: The Sexual Health Needs of Youth in Tobago Recommendations Health and social services Confidential, private, specialised health services for youth Youth health services should be integrated with other services Counselling and guidance services should be increased


The Sexual Health Needs of Youth in TobagoRecommendations: The Sexual Health Needs of Youth in Tobago Recommendations Males need outreach, guidance and mentoring education to improve accuracy of HIV/ AIDS knowledge Females need involvement of religious leaders awareness of the risks of unprotected sex with older men


Slide17: The Sexual Health Needs of Youth in Tobago Recommendations Community participation Projects should be small-scale building on existing social networks employing people who have achieved a position of trust