High Risk Behavior, perceived peer behavioral norms, and self-reported attitudes of risk behavior in adolescents in the Caribbean

Introduction: Risk and protective factors were assessed in Caribbean youth. Study behaviors included substance use and sexual activity. Guided by the theory of Reasoned Action (TRA), (i.e. intentions to engage in high-risk behaviors mediate the relationship between attitudes, peer/adult subjective norms and high-risk behaviors), the influence of peer behavioral norms on high-risk behaviors and perceived risk was evaluated. Methods: With IRB and local authority approval, secondary students ages 14-25 (males=627; females=724) completed anonymous questionnaires (CDC-YRBS influenced). Secondary schools were randomly selected from comparable faith-based schools in rural and urban communities in several Caribbean countries. Results: Age of first sexual intercourse and perceived risk of contracting HIV was significantly correlated (the higher the perceived risk the older the age). HIV/AIDS education in school correlated with older age of first sexual intercourse. Believing that peers “thought it was ok to have sex” was correlated with younger age of first sexual intercourse. The perceived risk for contracting HIV/AIDS for peers was significantly higher than for self. Conclusions: The study provides some confirmatory data and insight into TRA applications. The correlation between peers attitudes toward sexually high-risk behaviors and own behaviors is in keeping with the theoretical model. Second, the correlation of HIV/AIDS education with delaying sexual intercourse provides evidence that school interventions are able to influence the norm reference group of adolescents, thereby impacting intent and ultimately behavior. The perception that peers with similar high-risk behaviors are more likely to contract HIV provides novel insight into the internal reasoning process of these adolescents.