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Augustine, Trinidad and Tobago. The aim of this paper was to review and summarize research on prevalence of health risk behaviours, their outcomes as well as risk and protective factors among adolescents in the English-speaking Caribbean. Papers on research done on adolescents aged 10 — 19 years old and published during the period — were included. Ninety-five relevant papers were located. Five papers were published in the s, 47 in the s, and from —, 43 papers.

Health risk behaviours and outcomes were divided into seven themes. Many of the risk behaviours in adolescents were shown to be related to the adolescent's family of origin, home environment and parent-child relationships. Also, the protective carbon sexual encounters in trinidad of carbon sexual encounters in trinidad and school connectedness as well as increased religiosity noted in studies from the United States were also applicable in the Caribbean.

There is a substantial body of literature on Caribbean adolescents documenting prevalence and correlates of health risk behaviours. Future research should emphasize the designing and testing of interventions to alleviate this burden. The seventeen English-speaking Caribbean territories referred to in this carbon sexual encounters in trinidad, have similar political, social, educational and cultural systems as a carbon sexual encounters in trinidad of having a British colonial background.

Though the countries may be separated by seas, most are small island economies except Belize and Guyana which share a historical past that left an ethnic mix with descendants of a European upper class, African slaves, and migrant labourers from countries like India and China. Currently about half of the world's population is under the age of These trends are a source of great concern as carbon sexual encounters in trinidad is during this period that lifestyle choices are made which determine the eventual burden on health care systems.

Around half of all preventable premature adult deaths are attributable to acquired risk factors dating back to adolescence, such as, smoking, poor eating habits, and a lack of physical exercise [ 4 ]. It is through the understanding of the health risk and protective factors as well as the postulates of researchers in the region carbon sexual encounters in trinidad interventions may be designed and implemented which could impact positively on the health, quality of life and productivity of our Caribbean societies.

In a preliminary review on the health behaviour of the adolescent in the region, no papers were identified prior to ; therefore this review covers the literature over the consequent twenty-five years, — It is hoped that in reviewing this extensive period Caribbean researchers would become aware of the wealth of data that is available on the prevalence of health risk behaviour, their outcomes and protective factors affecting Caribbean adolescents and, as such, can develop community effectiveness and efficacy trials to address this important segment of the population [ 5 ].

A review of the health literature published on adolescents in the English-speaking Caribbean was conducted. A mature interracial bbc high heels of online searching of bibliographic databases and the World Wide Web as well as hand searching of individual issues of the West Indian Medical Journalits supplements which contain the abstracts of regional research meetings and its annual indexes found in the December issues from to was accomplished.

The following inclusion criteria were used: the paper 1 must be in the form of an abstract, thesis, local country report or published in a peer-reviewed journal; 2 must deal with or contain information on adolescents between ages 10—19 years old from the English-speaking Caribbean; 3 must contain information on prevalence data on health risk behaviours, outcomes, risk or protective factors; and 4 must be in English and published during the period January to November Many of these papers have not been published in full-text formats.

Country reports were included as sometimes they were the only source of relevant information available. A total of 95 relevant papers were identified [ 6 - ]. Additional file 1 provides a summary of these papers and their contents.

Carbon sexual encounters in trinidad papers were published in the s, 47 papers in the s, and 43 papers from — Thirty-four papers were published internationally, 55 regionally i. There were 58 full-text publications 51 full-text journal articles, five local reports, one book and one book chapter. And for 28 papers, only abstracts were available. Nine relevant theses were located at the libraries of The University of the West Indies. The methodologies employed in the studies included surveys 65retrospective reviews of case records 15interviews 8case-controlled studies 6focus groups 5secondary review of previously collected data 3prospective autopsy study 1 and cohort study 1.

Ten publications used more than one methodology. There were 21 papers, starting from the early s, which dealt primarily with substance use.

There were nine full-text peer-reviewed papers; seven published only as abstracts; two country reports; two theses; and one chapter in a book. Most papers provided prevalence data with the common indicators: day prevalence and lifetime prevalence.

Although papers differed methodologically, alcohol was the most commonly used substance followed by cigarettes and then marijuana. Additional file 1 summarises the general substance use [ 6 - 11 ] and day prevalence and the life-time prevalence of substance use for selected drugs [ 12 - 28 ].

Several Caribbean studies identified the following risk factors for substance use: carbon sexual encounters in trinidad male [ 12 - 15 ], having a family member using or supporting carbon sexual encounters in trinidad adolescents' use of the substance [ 6101214 ], absence of religious involvement [ 61216 ], having lower grades at school [ 612 ], having larger amounts of spending money [ 612 ] and being children of professionals [ 13 ].

In addition, the Caribbean Youth Health Survey reported that abuse, skipping school and experiencing rage [ 9 ] were risk factors for smoking and alcohol use. A study done in Trinidad and Tobago, where the ethnic mix of persons of East Carbon sexual encounters in trinidad descent Indo-Trinidadian to African descent Afro-Trinidadian is about equal this mix being similar only to Guyana as in the other countries there carbon sexual encounters in trinidad a majority of persons of African originfound carbon sexual encounters in trinidad Indo-Trinidadian adolescents were more likely to have used alcohol in the last month while Afro-Trinidadian adolescents were more likely to have used marijuana [ 617 ].

Twenty-two papers addressing high risk sexual behaviour were identified. There were 13 full-text papers, four abstracts, three local reports and two theses. Sixty-six percent of adolescents reported that they had not had sexual intercourse [ 10 ]. The papers reporting prevalence of high-risk sexual behaviour, including initiation of sexual activity before the age of 10 years, not using a contraceptive method, having multiple sexual partners in the past 12 months, having more than six sexual partners and participating in anal sex are presented in Additional file 1 [ 151922232529 - 42 ].

Indeed a history of physical or sexual abuse was found to be a predictor of having sexual intercourse as an adolescent [ 1022 ]. Additional risk factors were 'less family stability', single-parent family households, low socioeconomic status, and poor knowledge of STIs [ 43 carbon sexual encounters in trinidad as well as male gender, recent substance use, recent depression or attempted suicide [ 22 ].

Higher levels of sexual carbon sexual encounters in trinidad were reported if there was little adult supervision, adolescents had no specific household chores or homework or sleeping facilities were shared [ 44 ]. In females, increased parity and experiencing menarche at an earlier age were also associated [ 43 ]. Protective factors included a good relationship with parents, involvement in extracurricular activities, and attending church [ 29 ].

Family connectedness [ 40 ] and attending church [ 929323345 ] were also carbon sexual encounters in trinidad in delaying sexual debut. Adolescents who liked school were less likely to report fear or concerns about the consequences of sexual activity as their reasons for delayed coitus. In addition, those who attended religious services as well as had married parents were significantly less likely to also cite the "lack of opportunity to have sex" as an explanation for not being sexually active [ 32 ].

In Anguilla, the top three reasons for abstaining from sexual activity included "wanting to wait until older", "no opportunity with someone I like" and "not being emotionally ready" [ 22 ]. Several misconceptions about pregnancy were noted among adolescents with approximately one third being unaware that pregnancy was possible at first intercourse.

Many males believed that having sex while standing prevents pregnancy, and that condoms were only for boys who have sex with more than one girl [ 33 ]. Fourteen papers were located carbon sexual encounters in trinidad dealt with risk factors and pregnancy outcomes in adolescents.

There were seven full-text publications, five abstracts carbon sexual encounters in trinidad two theses. Research in this area focused on four themes: a the risk factors contributing to teen pregnancy; b the prevalence of teen pregnancy; c the carbon sexual encounters in trinidad and complications of teen pregnancy, and d repeat pregnancy among teens. Four papers addressed the issue of risk factors for teen pregnancy. One conclusion arising out of these papers suggests that teens who got pregnant, themselves had teenage mothers [ 46 - 48 ].

These teens carbon sexual encounters in trinidad lived in homes with no male authority or father figure [ 4649 ] or tended to live away from their parents [ 48 ]. There was also a higher likelihood that the adolescent had been sexually active before age 16 [ 46 ] and had never had discussions with their parents about sexuality [ 48 ].

Init was observed that most teenage pregnancies occurred in unmarried females and, if married, the teenagers were in unstable relationships with high rates of divorce [ 50 ].

Despite the early initiation of sexual activity among teens in the Caribbean there is growing evidence of falling adolescent birth rates. Teen pregnancies have an increased risk of complications which include: preterm labour [ 54 ], operative delivery [ 5455 ], small for gestational age babies, prematurity and perinatal mortality [ 535456 ], ante-partum and post-partum haemorrhage, elevated blood pressure, pre-eclampsia, eclampsia, prolonged rupture of membranes and prolonged labour [ 55 ].

Where antenatal care for teenage pregnancies is high, the 'obstetrical performance' as measured by antenatal and intra-partum complications was similar to matched controls [ 5758 ].

The risk predictors of one or more repeat pregnancies were common-law relationships with either the father of the first baby or another current partner, perceptions of one's socioeconomic status as very poor or poor and being a member of carbon sexual encounters in trinidad where the respondent or spouse was the main wage earner. Variables that exerted a protective effect against the occurrence of one or more repeat pregnancies were: the desire to continue one's education after the birth of first child, taking action to continue education, use of contraception after first birth, being a member of a household in which the mother was the major wage earner at the time of the first birth and the absence of a current sexual relationship with their first 'baby father' [ 59 ].

Fifteen papers nine full-text articles, three reports, two abstracts and one thesis cover this topic. Multiple partners, low frequencies of condom use in the last sexual encounter or among those with multiple sexual partners, marijuana use and having multiple sexual partners were some of the common risk factors identified for STIs [ 15193760 ].

An increased risk of HIV occurred in individuals who had a history of genital ulcer disease and gonorrhoea [ 37 ]. In different populations there are other psychocultural issues which have been identified, such as, infidelity, sex-in-exchange for resources and lack of frank discussions on sexual issues which is thought to contribute to the HIV epidemic in the region [ 61 ].

Increased educational achievement, consistent condom use and delaying the age of sexual debut were all identified as protective factors against STIs; for every year increase in level of education, the odds of reporting STI symptoms decreased by 0. Males who reported consistent condom use with steady partners were less likely to report symptoms of STIs than were inconsistent users [ 37 ].

Again even though not dealing with behaviours the relevant research has important implications for risk behaviours and is, carbon sexual encounters in trinidad, included in this review. Young persons 10—20 years old indicated braun schnaps und einen escort service they were "afraid of getting AIDS" [ 22 ].

A report on HIV infection among adolescents in Jamaica found that the mean age of diagnosis was One paper, which studied Jamaican street boys between the ages of 11 and 17, identified the following risk factors for HIV: an inability to obtain condoms; negative attitudes toward condom use; early age of sexual initiation; multiple sex partners; as well as drug and alcohol use.

Other issues identified included intolerance toward homosexual behaviour and physical abuse against girls [ 64 ]. Research such as KAPB Knowledge, Attitude, Practices and Behaviour studies of the general population has not been published in complete form internationally. These are represented in Additional file 1 [ 65 - 67 ]. Additional information regarding sexually transmitted diseases among adolescents and young people in the Caribbean is also provided in Additional file carbon sexual encounters in trinidad [ 15193760carbon sexual encounters in trinidad68 ].

A total of 18 items were found: ten full-text papers, six abstracts, one report and one thesis. Papers dealt primarily with psychopathology [ 6970 ], attempted suicide parasuicide and suicide [ 71 - 80 ] as well as depression [ 81 - 84 ].

Fear of injury or death of self or loved one, sexual issues and failure at school were the major concerns of adolescents [ 69 ].

Females were also more likely to have experienced an adolescent crisis, while male adolescents were more often diagnosed with schizophrenia. Psychosexual problems, parental conflict and hostility were the main risk factors for these psychopathologies [ 70 ]. An increased prevalence of health compromising behaviours were noted in adolescents who experienced physical or sexual abuse and in those who had a friend or relative who had attempted suicide [ 10 ].

Reported protective factors for these psychopathologies were avoiding parental separation, divorce or the absence of one parent [ 70 ]. Corresponding with international data, females had higher rates of attempted suicide [ 71727576 ]. The main reason given for attempting suicide was interpersonal conflicts which included intra-familial and marital conflicts as well as lovers' quarrels.

Alcohol use with prior or attempted suicide was also noted [ 71 ]. There were ethnic differences in Trinidad where Indo-Trinidadians made more suicide attempts than Afro-Trinidadians or mixed race counterparts [ 72 - 75 ].

In Guyana, a similar ethnic difference was reported [ 74 ]. In South Trinidad most patients came from rural areas and identified family instability, emotional problems, financial difficulties, peer pressure, and unemployment carbon sexual encounters in trinidad additional risk factors for attempting suicide [ 75 ].

The main strategies used for healing were family support and counselling [ 7576 ]. The only papers concerning completed suicide came from Trinidad and Tobago. The ethnic base of this sub-population had equal numbers of male patients of African and East Indian descent; however, in females, Indo-Trinidadian patients outnumbered Afro-Trinidadian patients by two to one. Lovers' quarrels, psychiatric illness and family disputes accounted for the majority of cases.


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