Measurement approaches to identifying high risk youth: A comparison of three methods

Few studies compare strategies for identifying persons at high risk of HIV and unintended pregnancy, and no studies have specifically determined the applicability of varying methods for identifying youth at high risk of these negative outcomes. This study compares socio-demographic and sexual behaviors of youth (ages 15-24) in Port-au-Prince, Haiti surveyed in a) their households in the 2005/6 Demographic and Health Survey, b) a 2004 clinic-based study, and c) a 2006/7 venue-based study (using the PLACE methodology). Youth in the clinic sample were more likely to report sexual experience compared to youth surveyed using the other two approaches. A greater proportion of sexually experienced youth in the PLACE study sexually debuted before age 12, had multiple sexual partners in the last year, and used condoms at last sex compared to youth in the clinic and household surveys. Among sexually experienced female youth from the PLACE study, 10% reported receiving money or gifts for sex in the last year, compared to 2% in the clinic sample. At first and last sex, more female and male youth in the PLACE study reported using contraception than in the clinic sample. Pregnancy experience was most common in the clinic sample; however, among ever-pregnant youth, those in the PLACE study were more likely to report ever having an abortion. Program managers seeking to target activities to high-risk youth would be better served to identify youth in clinics (missing youth without access to services) or use the PLACE methodology to identify youth in locations where high-risk behaviors take place.