Background: Adolescents are at increased risk for unplanned pregnancies and STIs, including HIV. Haitian American adolescents remain understudied, despite their vulnerability to risky sexual activities, and experience the same structural and psychosocial problems (inadequate housing, education, and employment, delinquency, and marginalization/stigma) that disproportionately place other minorities at risk for HIV/STIs.
Methods: This study explored contextual variables related to sexual activity (SA) among 276 Haitian American adolescents in Miami who were participating in a sexual risk reduction intervention (2000–2005). At baseline, participants completed the NIH-developed Problem Oriented Screen Instrument for Teenagers, including the POSIT HIV/STD-Risk Mini-Questionnaire. These measures examined five domains of risk in adolescents’ lives: Individual, Peer, Family, School, and Neighborhood. SA was measured by participants’ reports of ever engaging in oral, anal, or vaginal sex. T-test and Chi-square were used to evaluate bivariate associations between SA and variables measuring the above domains. Variables that were significantly associated with SA at alpha ± 0.10 were entered into a logistic regression model to identify their independent associations with SA.
Results: In the overall sample, 51% males and 36% females were sexually active, and their median (SD) age was 16.0 (1.2) years. In multivariate analysis, age (Adjusted Odds Ratio [AOR]:1.6, 95% CI:1.18– 2.15), females (AOR:0.42, 95%CI:0.20–0.85), communication about sex (AOR:1.11, 95%CI: 1.04–1.2), currently living with mother only (AOR: 3.10, 95%CI: 1.54–6.20), and currently having sexually active friends (AOR:2.96, 95%CI: 1.31–6.66) were significantly associated with SA. In a female sub-sample, age, sexual communication ability, mental health, and household composition were independently associated with sexual activity (p<0.05).
Conclusions: These findings offer important insight into the sexual behaviors of understudied and vulnerable Haitian American adolescent subgroup. The study reinforces the importance of probing gender differences and the roles of peer norms, sexual communication, and family household situation.