HIV-related risk factors in a population-based probability sample of North and Central Trinidad: The Voluntary HIV-1 Counseling and Testing Efficacy Study

A population-based probability sample of North and Central Trinidad collected information on 860 respondents' demographic characteristics, as well as the prevalence of sexual risk behaviors and precursors to sexual risk taking in the 2 months preceding interview. Precursors of sexual risk behavior included HIV transmission knowledge, condom possession, and alcohol and drug use prior to sexual intercourse. A 91% response rate was achieved. Overall, approximately 51% of respondents reported unprotected sexual intercourse with a primary sex partner (i.e., spouse or 'steady' partner), and 4% reported unprotected sexual intercourse with a nonprimary partner (i.e., casual or commercial partner) during the 2 months prior to interview. Substantial variability on these risk behaviors was noted across demographic strata. Alcohol and drug use prior to intercourse was associated with reports of unprotected intercourse with primary and nonprimary partners. Those who kept condoms at home were less likely to report having unprotected sexual intercourse with both primary and nonprimary partners. The demographic indicators of marital status and respondent gender had indirect (i.e., mediated) effects, through one or more of the risk precursors, on sexual risk behaviors. Implications for the design and targeting of HIV-related interventions and services are discussed.