Poor educational attainment and sexually transmitted infections associated with positive HIV serostatus among female in-patient substance abusers in Trinidad and Tobago

Action research improves services for child sexual abuse in one Caribbean nation: An example of good practice

BACKGROUND

Child sexual abuse (CSA) is a multi-dimensional problem. The search for best practice must consider the complexities surrounding CSA and its management in any particular society.

OBJECTIVE

Data previously gathered from service providers on CSA service provision in Trinidad and Tobago identified key deficient issues in policy and practice. In this paper, researchers aimed to bridge the gaps identified, and effect changes to improve services for CSA using an action research methodology.

PARTICIPANTS AND SETTING

Service providers from all sectors in governmental and non-governmental organizations in Trinidad and Tobago, who work with children at risk of CSA were involved in the process.

METHODS

Researchers led the service providers into an awareness of their own practice through critical discussion of, and reflection on, the key deficient issues. The new knowledge generated, with guided input from evidenced-based best practice, led to the development of guidelines for management. Discussion of the practicability of the guidelines by service providers in multiple sectors generated more new knowledge that refined the management approach.

RESULTS

The contextual knowledge obtained from service providers resulted in best practice guidelines for service providers that were culturally relevant and context-sensitive, adaptive and implementable, and allowed a seamless multidisciplinary response to CSA in Trinidad and Tobago within prevailing constraints.

CONCLUSIONS

Action research offers an effective approach to improve services for CSA through mobilization of service providers and changes in policy and practice. It is applicable in any setting and likely to be effective in any socio-cultural context.

Prevalence and clinical correlates of chlamydia infection in youth who use drugs and alcohol: a good opportunity for early intervention

AIMS

This study estimates the prevalence of chlamydia infection amongst teenage substance users aged 14-18years and investigates risk factors associated with a positive diagnosis of chlamydia infection.

METHODS

Data was collected from the medical files of adolescents who attended a statewide drug and alcohol treatment facility during a three-year period commencing June 2011.

RESULTS

The highest rate of chlamydia detection (18.0%) was found in the group with a reported history of abuse, a non-substance use psychiatric diagnosis, and individuals who did not complete year 10 education.

CONCLUSION

Adolescents attending a detoxification facility are a suitable group for targeted chlamydia infection screening and early treatment.

Breaking the silence of child sexual abuse in the Caribbean: a community-based action research intervention model

In Trinidad and Tobago, little data exists on child sexual abuse, although there are many anecdotal reports of high prevalence. The Breaking the Silence Gender and Community Empowerment Model is a multidisciplinary intervention to prevent and respond to child sexual abuse in Trinidad and Tobago. It is an innovative, gender-sensitive intervention that uses a community based action research methodology anchored in a national framework. Preliminary evaluation of the Breaking the Silence model shows increased knowledge of child sexual abuse, increased willingness to discuss child sexual abuse, and an impact that goes beyond the target communities. This model can be replicated in communities to prevent and respond to child sexual abuse and adapted to address other sensitive social issues in the Caribbean.

Alcohol, drugs, sexual behavior, and HIV in Trinidad and Tobago--the way forward

The HIV epidemic in Trinidad and Tobago is primarily heterosexual, fueled by a high level of risky sex, gender inequality, and alcohol and drug use; however, the influence of alcohol and drugs has been neglected in the literature. Research shows that current HIV prevention approaches have failed to substantially impact sexual behavior change. This may be so because they do not incorporate a comprehensive understanding of the sociocultural factors underlying sexual behavior. There is an urgent need to understand how socially accepted patterns of alcohol and drug use contribute to sexual behaviors and HIV risk in Trinidad and Tobago. Moreover, specialized, evidence-based interventions are needed for HIV-infected substance abusers. Using an adaptation of the cognitive behavioral stress management (CBSM) protocol, this intervention project aimed to assess effectiveness in reducing relapse and risky behaviors among recovering HIV-infected substance abusers in Trinidad and Tobago.

Sex, drugs and sexually transmitted infections in British university students

Summary:

Understanding predisposing factors for sexually transmitted infections (STIs) in young adults may identify targets for public health interventions. We conducted a cross-sectional web-based survey of university students’ sexual attitudes, behaviours and lifestyles and self-reported rates of STI. A total of 827 students responded, 22.4% had two or more sexual partners in the previous year with inconsistent condom use and the lifetime prevalence of STIs was 9.6%. Factors associated with a diagnosis of STI were increasing age and number of sexual partners ever, female gender (adjusted odds ratio [AOR] 2.70, 95% confidence interval [CI] 1.31, 5.56) and use of crack (AOR 10.45, 95% CI 1.46, 75.16). For female students, these were increasing age and number of partners ever, whereas for male students having sex with other men (bisexual AOR 4.8, 95% CI 1.02, 22.595, homosexual AOR 17.66, 95% CI 3.03, 103.04) and use of crack (AOR 32.24, 95% CI 3.33, 312.08). Multiple partners and recreational drug use may predict incidence of STI. Prevention strategies need to aim at reducing risk behaviour across various activities.