Correlates of sexual activity and inconsistent condom use among high-school girls in Dominica

OBJECTIVE: To determine factors associated with sexual activity and inconsistent condom use among high-school girls in Dominica. METHODS: A cross-sectional study was conducted at five high-schools in Dominica in 2000 to assess behaviour that may put high-school girls at risk for HIV The main outcome variable, sexual activity, was defined as vaginal or anal sex, and inconsistent condom use defined as none to infrequent condom use. The convenience sample consisted of 204 girls (median age 16 years). RESULTS: Forty-one per cent (41%) of girls reporting at least one episode of sexual activity. Sexual intercourse was associated with past sexual coercion (OR = 7.2, 95% CI 2.4, 21.8), oral sex (OR = 8.0, 95% CI 3.0, 21.0) and smoking marijuana (OR = 8.2, 95% CI 2.9, 23.0). Among sexually active girls, 59% were inconsistent condom users. Variables associated with inconsistent condom use were being coerced (OR 2.8, 95% CI 0.9, 8.2) and low socio-economic status (OR 3.3, 95% CI 1.1, 9.6). CONCLUSION: Sexual activity and inconsistent condom use occur frequently among high-school girls in Dominica. Therefore, strategies directed at delaying the onset of sexual activities such as providing accurate and age-appropriate information on sexuality in the context of the economic and social conditions of their daily lives, and increasing condom use are important in HIV prevention in this population.