Abstract
BackgroundThe aim of this study was to establish the prevalence and risk factors for intergenerational (IG)-sex in females aged 15–19 residing in Barbados.MethodsThis cross sectional cluster survey was conducted in a 2.6% national sample in the age range (n = 261) recruited from multiple polling districts chosen with a probability proportional to size. Consent was obtained from participants aged ≥18 years or from parents/guardians of participants <18 years, with participant assent. The prevalence of age at first sex was analyzed using a life table approach and risk factors for IG sex (defined as sexual relations with a male 10 or more years older) were analyzed by logistic regression, adjusting for age.Results51.0% of adolescent females in the survey reported ever having had sex, among whom prevalence of IG-sex was 13.2% (95% CI: 6.7-19.8) at first sex, 29.0% (22.3-35.7) within the preceding twelve months, and 34.8% (24.3-45.4) ever. Condom use at first sex was positively related to willingness to have sex (F statistic = 9.8, p = 0.001). The strongest determinant for IG-sex was age of sexual debut (age adjusted Odds Ratio [95% CI]: 0.58[0.41-0.83]), followed by money or gifts received from the partner (2.91[1.17-7.23] and self-esteem (0.33[0.11-0.95]).ConclusionsThe survey establishes a high rate of IG-sex in Barbados, a ‘high income’ country. Most insightful is that risk of IG-sex nearly halved for every year at which first sex was delayed. A high proportion of coerced sex was reported at first sexual experience and this was linked to poor condom use. Affirmative prevention approaches are recommended to boost self-acclamation of adolescent women within less coercive relationships, especially during their first sexual encounter.
Highlights
The aim of this study was to establish the prevalence and risk factors for intergenerational (IG)-sex in females aged 15–19 residing in Barbados
Research in Africa supports the existence of a link between IG-sex and HIV infection among adolescent females
In sub-Saharan Africa, adolescent women aged 15–24 were between 2 to 4 times more likely to be infected than their male contemporaries [11], while research by Kelly et al (2003) identified large age differences in sexual relationships as a contributing factor to HIV prevalence [12]
Summary
The aim of this study was to establish the prevalence and risk factors for intergenerational (IG)-sex in females aged 15–19 residing in Barbados. In Barbados the overall prevalence of HIV remains higher in men, but in the age group 10–19 it is more prevalent in women [2]. This signifies a major shift for a disease originally concentrated within the male population. In sub-Saharan Africa, adolescent women aged 15–24 were between 2 to 4 times more likely to be infected than their male contemporaries [11], while research by Kelly et al (2003) identified large age differences in sexual relationships as a contributing factor to HIV prevalence [12]. A study of adolescent women aged 15–24 in rural Zimbabwe concluded that each one-year increase in age difference between partners was associated with a 4 percent increase in risk of HIV infection [13]
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