HIV risk perception among adolescents in Trinidad and Tobago

Background: Fueled by heterosexual transmission HIV infection rates are increasing in Trinidad and Tobago (T&T), especially among adolescents. This study examined risk perception among younger and older adolescents, 12-18 years old, residing in T&T.

Method: Surveys (N=97) and focus groups (N=8) were conducted among high school students in T&T. Surveys provided data on HIV knowledge, attitudes, and sexual and drug use behaviors. Focus groups reported on HIV knowledge and personal and peer group sexual and drug use behavior. Student and non-student key informant interviews (N=23) were used to triangulate focus group reports.

Results: Data showed that students used condoms inconsistently and older and younger males had three times more sexual partners than female adolescents. Females were less knowledgeable about condoms as HIV prevention tools. Most adolescents reported that condom use would make a partner think they don't trust them. Focus group participants had incorrect knowledge about HIV transmission and prevention and little knowledge about availability of HIV treatment. According to focus group participants and key informants issues of status attainment, youthful invincibility, pressure from boys, and partner relationships influenced risk perception.

Conclusion: Knowledge alone is not sufficient to create change in risk perception or health behaviors but is important in the behavior change process. Incorrect knowledge and underestimation of risk can lead to negative health outcomes. HIV transmission, prevention, and treatment education are needed in T&T high schools. Contextual factors influencing adolescent risk perception such as status attainment need to be further examined in order to develop age-appropriate adolescent interventions.