Of the disadvantaged groups, out-of-school youth are at particular risk for contracting HIV. Approximately one-third of people living with HIV/AIDS in the region are between the ages of 15 and 24. These high rates of infection are due to a lack of HIV-prevention knowledge, lack of access to youth-appropriate sexual health services and the prevalence of high-risk sexual behaviours – a deadly combination of factors. In areas of intense poverty and social marginalisation, such as the Haitian-dominated batey settlements in the Dominican Republic, comprehensive knowledge of HIV prevention is abysmal. Only 34% of young women and 26% of young men demonstrate sufficient understanding of how to protect themselves against the spread of HIV or sexually transmitted infections – significantly lower levels of knowledge than the general youth population. In addition to low levels of HIV knowledge, CARISMA partners have found that the practice of sexual concurrency (having multiple sexual partners) is more common among young women throughout the region than previously thought [footnote PEER (Trinidad and Jamaica) – additional research].
In response to the prevalence of high-risk sexual behaviour and low levels of HIV related knowledge, CARISMA partners have focused their efforts on awareness-raising mass media campaigns and community-level outreach education. In the first phase of the CARISMA project, partners have made important steps towards improving the sexual health of at-risk Caribbean youth. CARISMA’s partners have reached out to nearly 7,000 youth and 1,300 Carib youth in the Eastern Caribbean and the Dominican Republic with one-on-one and small group peer education outreach. In Haiti, a youth-targeted mass media campaign (Abrite W) and the circulation of a youth-focused quarterly magazine (Journal Jeune) have helped to increase HIV prevention knowledge among this key population. Targeted behaviour change communication projects for out-of-school youth have raised awareness among this vulnerable sub-population. In the Dominican Republic, the highly popular Amor de Batey soap opera has proved to be a particularly effective method for inserting safe sex messages into youth culture.
In Phase II of the CARISMA project, partners will intensify their targeted outreach and mass media campaigns to better reach Caribbean youth. PSI/DR will build on a recent PEER batey youth study to develop effective mass media campaigns and BCC materials that speak directly to this high-risk group. PSI/EC will continue to use peer youth educators at the local level in each of its country programmes in addition to the development of locally produced radio spots and the expansion of its youth-targeting “Got it? Get it.” condom campaign.
Taken together, CARISMA’s youth-focussed initiatives have the potential to decrease the spread of HIV and AIDS in this high-risk, highly vulnerable, and previously underserved population.