Nearly half of sexually active Jamaican adolescents report using condoms inconsistently or not at all in the last year, according to a new study by Kanako Ishida, of the Centers for Disease Control and Prevention, et al., published in International Perspectives on Sexual and Reproductive Health. Given that the Caribbean region has the second highest HIV prevalence in the world, the authors believe that it is critically important for Jamaican reproductive health education programs and interventions to address this behavior.

Ishida et al. note that despite past research documenting Jamaica’s high levels of adolescent sexual activity, there are few recent reliable estimates on the national prevalence of risk behaviors and associated factors. In their analysis of data from a 2008–2009 nationally representative survey, among 15–19-year-olds who were neither married nor had a child, 54% of the males and 32% of the females had had sex in the previous year. Among the sexually active adolescents, 46% of males and 49% of females had used condoms inconsistently or never during that period, and 52% and 12%, respectively, had had more than one partner.

For both males and females, regular attendance at religious services was the factor most strongly associated with lower levels of the measured risk behaviors—sexual activity, inconsistent use or nonuse of condoms and having multiple partners. A similar association emerged for school enrollment but differed for males and females: For males, enrollment in a grade lower than appropriate for their age—rather than in an age-appropriate or higher grade—was strongly associated with not being sexually active and not having multiple partners, whereas for females, enrollment in an age-appropriate or higher grade was strongly associated with not being sexually active and with using condoms consistently.

Aside from school and church attendance, Ishida and her colleagues also found that experiences of family violence and adult support (or lack thereof) influenced adolescents’ sexual risk behaviors. Females who were victims of childhood violence had an elevated risk of being sexually active, while adolescent males who had witnessed parental violence were more likely to be sexually active and to have multiple partners. In addition, females who lived with a supportive adult had a lower risk of being sexually active or of using condoms inconsistently or never.

Given that adolescents who regularly attend church and school are less likely to engage in risky sexual behavior, the authors recommend that programs need to focus on other adolescents, who may have a greater need for services. In addition, they argue, interventions need to be designed for the differing needs of males and females.

The authors conclude that although contraceptive use and average age at first sex have increased steadily over the past decade in Jamaica, the findings in this study point out the ongoing need for programs that help adolescents make smart decisions about their sexual health.

The article "Prevalence and Correlates of Sexual Risk Behaviors Among Jamaican Adolescents" appears in the March issue of International Perspectives on Sexual and Reproductive Health .

Also in this issue of International Perspectives on Sexual and Reproductive Health:

"Injected with Controversy: Sales and Administration of Injectable Contraceptives in Uganda," by John Stanback of Family Health International, et al.;

"What Differentiates Method Stoppers from Switchers? Contraceptive Discontinuation and Switching Among Honduran Women," by Janine Barden-O'Fallon of University of North Carolina, Chapel Hill, et al.;

"Associations Between Family Factors and Premarital Heterosexual Relationships Among Female College Students in Tehran," by Farideh Khalaj Abadi Farahani of Centre in Asia and the Pacific, et al.; and

Comment, "Postabortion Care: Going to Scale," by Saumya RamaRao of the Population Council, et al.