Using Multiple Sampling Approaches to Measure Sexual Risk‐taking Among Young People in Haiti: Programmatic Implications

Abstract

No studies have examined the applicability of varying methods for identifying youth at high risk of unintended pregnancies and contracting HIV. This study compares sociodemographic characteristics and sexual behaviors of youth (ages 15-24) in Port-au-Prince, Haiti surveyed using three different study methodologies. The three study methodologies are compared in terms of their utility for identifying high risk youth and utility for program planning. The three study methodologies are: a representative sample of youth from the 2005/6 Demographic and Health Survey (HDHS); a 2004 facility-based study; and a 2006/7 venue-based study that used the Priorities for Local AIDS Control Efforts (PLACE) method. The facility-based and PLACE studies included larger proportions of single, sexually experienced youth and youth who knew someone with HIV/AIDS than the HDHS. More youth in the PLACE study had multiple sexual partners in the last year and received money or gifts for sex compared to youth in facilities. At first and last sex, more PLACE youth used contraception including condoms. Pregnancy experience was most common in the facility-based data; however, more ever-pregnant PLACE youth reported ever terminating a pregnancy. Program managers seeking to target prevention activities should consider using facility- or venue-based methods to identify and understand the behaviors of high-risk youth.

A Venue-Based Approach to Reaching MSM, IDUs and the General Population with VCT: A Three Study Site in Kenya

“…In previous comparisons to household studies, the PLACE method captured individuals who reported higher sexual risk behaviors. [4–6] The PLACE Kenya study is the first time it has been possible to compare HIV prevalence obtained from the PLACE approach versus a household survey.…”

Evidence of high-risk sexual behaviors among injection drug users in the Kenya PLACE study

“…This methodology is based on epidemiology theory which indicates that there is often geographic clustering of HIV transmission (Grassly et al, 2001; Wasserheit and Aral, 1996; Weir et al, 2005) and has been described elsewhere (Weir et al, 2004). The PLACE method has been implemented in over 60 countries and has been shown to be more effective in capturing the individuals with riskier sexual behaviors compared to household surveys (Speizer et al, 2009; Tate et al, 2010; Weir et al, 2004). …”

Maternal HIV Illness and its Impact on Children’s Well-being and Development in Haiti

“…Economic insecurity, ‘lamize’ or economic despair in Creole, has been reported to be associated with early initiation of sex and dependence on sexual relationships for survival among Haitian youth, where 15% of boys and 11% of girls who were sexually experienced report exchanging money for sex in the past 4 weeks (Speizer, Beauvais, Gómez, Outlaw, & Roussel, 2009). Lastly, the lack of opportunity to attend school may also provide children with more unstructured time to seek out risky sexual behaviors that may lead to HIV infection.…”