Marseille 2007
Marseille 2007
Abstract book
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Abstract #405  -  HIV risk behaviours in the Caribbean
Session:
  26.100: Posters B (Poster) on Tuesday   in  Chaired by
Authors:
  Presenting Author:   Dr Gaelle Bombereau - Caribbean Epidemiology Cebter (CAREC-PAHO-WHO), Trinidad And Tobago
 
  Additional Authors:   
Aim:
In the Caribbean, second highest HIV prevalence in the world, the behaviors which drive the HIV epidemic are mainly sexual. Consequently, fighting the epidemic means dealing with private behaviours and in some cases, behaviours considered as illegal in most of the countries (such as homosexuality, sex work, sexual abuse) or economic behaviours (like prostitution, transactional sex) or cultural behaviours (like tolerance for outside partners, e.g. peer valorisation of multi-partnered men). Moreover, sexuality in the Caribbean swings between a social injunction of silence among women (especially girls) and a need to tell among men. Although improving our knowledge of sexuality trends in the Caribbean is critical, it is also quite challenging because of a deeply entrenched sexual taboo and social norms referred to above.
 
Method / Issue:
Through a meta-analysis of the main behavioural surveys (Behavioural Surveillance and Knowledge, Attitudes, Beliefs and Practices surveys) done within the Caribbean from 2000 2006, we will describe the main behaviours which drive the HIV epidemic in the region. A lack of uniformity in sample age ranges, sampling strategies and survey instruments makes it difficult to make comparisons and identify trends. Nevertheless, there is consistency in the broad patterns that emerge within the Caribbean i.e. age at first sexual experience is lower for males than females; high suspicion of sexual abuse/incest; multi- partnered men; consistently low condom use; low interest in HIV testing and high stigma and discrimination toward persons with HIV.
 
Results / Comments:
We will show that despite a high level of knowledge about HIV prevention methods (abstinence, faithfulness with an uninfected person, consistent condom use), there is still a huge gap between knowledge and practices. A second major gap will also be further explored regarding the high level of sexual risk behaviours (multi-partnership, low condom use, etc.) and the low percentage of people who get an HIV test. Vulnerabilities of women will also be further described.
 
Discussion:
There is a need to review and alter programmes to intervene on specific risky practices For instance: - Formulate policies that promote youth access to essential information, commodities, and services that reduce their risk of STI / HIV infection ( i.e: develop massive public sensitization programmes targeted mainly at headmasters, parents, teachers and churches to emphasize the need to provide young adults with access to condoms). - Review policy regarding distribution of condoms to youth at school, in health care settings, NGOs, etc. and then provide access to condoms (bathrooms, vending machines, etc.) - Promote consistent and correct condom use (especially in concurrent relationships and/or with non-regular partner) - Advocate for the review, revision and / or development of laws against rape, incest, paedophilia and child prostitution - Advocate for the review, revision and / or development of human rights laws that protect vulnerable and marginalized segments of the population - Advocate for policies and laws that ensure confidentiality protection related to HIV status, especially within the health and social sectors to help fight stigma and discrimination.
 
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