Sexual behaviors of adolescents place them at a high risk for HIV infection and other sexually transmitted diseases. International comparisons of sexual risk-taking among youth employing a common set of survey items are rare. Moreover, such studies can assist in explaining observed differences in disease rates, or predicting future trends in transmission, and identifying health educational needs unique to a particular population or setting. To assess variations in risk-taking patterns, a comparison of HIV behavioral risk factors was made between U.S. Hispanic and Dominican Republic (D.R.) youth. The Spanish version of the Youth Risk Behavior Surveillance (YRBS) survey was administered to 1,175 D.R. high school students. Responses were compared to those in the U.S. from the Centers for Disease Control and Prevention's 1990 YRBS data tape for 2285 Hispanic youth. Frequency and cross-tabulation data were compared by country and gender. There were significant differences in AIDS education at school, discussions about AIDS conducted in the home, age of first sexual experience, condom use, and past experience with STDs. Results show that adolescents in both countries are at risk, but with different mediating factors. Inadequate condom use and early initiation of sex place the D.R. youth at risk, while more U.S. youth are engaging in sexual intercourse and using alcohol or other drugs in conjunction with sexual episodes. Some implications for prevention education are discussed.
PIP: A comparison of human immunodeficiency virus (HIV) risk factors between US Hispanic and Dominican Republic youth indicated sexual intercourse under the influence of drugs and alcohol places the former group at risk, while early initiation of sex and inadequate condom use are the main risk factors in the latter group. The data on 2285 US Hispanic adolescents (mean age, 15.6 years) were derived from the 1990 Youth Risk Behavior Surveillance survey. A Southeastern-Puerto Rican version of this survey was administered to 1175 Dominican Republic youth (mean age, 16.8 years). 78.5% of US Hispanic youth and 59.9% of Dominican youth had been taught about acquired immunodeficiency syndrome (AIDS) in school, and 51.5% and 70.9%, respectively, had discussed AIDS at home. 54.1% of US teens (66.0% of males and 43.6% of females) and 31.0% of Dominican respondents (61.2% of males and 10.0% of females) were sexually active. 15% of US Hispanics had engaged in sex before 13 years of age, while 30.4% of Dominicans were sexually active by 12 years of age. Four or more life-time sexual partners were reported by 31.1% of US and 37.6% of Dominican youth. US Hispanics were more likely than Dominicans to have used drugs or alcohol prior to the most recent sexual intercourse (24.8% vs. 10.8%, respectively). The frequencies of condom use during the most recent intercourse were 38% and 34%, respectively. Continued unprotected sexual activity in this age group can have profound effects on the growth curve of HIV, suggesting a need for earlier and better sex education programs.