Vanessa Jones


Background. Human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) is one of the fastest spreading infectious diseases in the Caribbean, and is second only to Sub-Sahara Africa in the prevalence of HIV/AIDS cases. Trinidad and Tobago is the southernmost twin island republic in the Caribbean. In 1999, the 5th leading cause of death among individuals ages 15-34 in Trinidad and Tobago was HIV/AIDS. According to UNAIDS (2006), the prevalence rate of HIV in Trinidad and Tobago is 2.6%.

Purpose. Currently, there is no standardized HIV/AIDS education program in secondary schools in Trinidad and Tobago. Since HIV/AIDS is a health concern in Trinidad and Tobago and adolescents as young as 15 years of age have been infected the study was conducted to determine if providing adolescents with HIV/AIDS information will make them more aware of their susceptibility of becoming infected with HIV, and the severity of HIV. Additionally, I attempted to show that providing information about and demonstrating assertiveness skills regarding saying no to sexual advances will lead to an intention to delay sexual initiation.

Method. A quasi-experimental design was used with a treatment group (n=104) and a comparison group (n=92). The educational intervention was conducted once per week for the treatment and the comparison groups over 5 consecutive weeks, each session was 30-45 minutes in length. Participants completed a pre and post-test during the first and last sessions. Sessions 2-4 comprised the educational intervention. The health belief model (HBM) was used to develop the intervention and assess its impact among adolescents 11-18 years old in nine secondary schools throughout Trinidad and Tobago. Three of the five constructs of the HBM used to design the intervention were perceived susceptibility, perceived severity, and self-efficacy. The treatment group received an interactive, instructor led intervention which included three areas of HIV education: (1) basic facts about HIV, (2) ways to decrease the spread of HIV, (3) and assertiveness skills. The comparison group watched 3 videos about HIV/AIDS.

Results.The participants in the treatment group were younger (13.4 years) than those in the comparison group (14.7 years) (p=<.001). At pre-test, the comparison groups had higher scores on the knowledge items than those in the comparison group (p=.009) and maintained higher scores at post-test controlling for age, gender, and pretest values (p=.001). At post-test controlling for age, gender, and pre-test values the treatment group were more likely to plan to delay sexual initiation (p=.006).

Conclusions.The students in the comparison group were on average older than the students in the comparison group. At post-test there was a decrease in the comparison group scores on the variables of attitudes toward abstinence and delaying sexual initiation. Overall, there was a positive direction of change for the treatment group on the variables that were measured including intention to delay initiation of sexual activity.


School of Public Health

First Advisor

Naomi Modeste

Second Advisor

Helen Hopp Marshak

Third Advisor

Curtis Fox

Degree Name

Doctor of Public Health (DrPH)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Sexually Transmitted Diseases -- prevention & control -- Trinidad and Tobago; HIV Infections -- prevention & control -- Trinidad and Tobago; Sexual Behavior -- in adolescence; Sex Education; Attitude to Health; Interpersonal Relations; Social Perception; Health Surveys.



Page Count

x; 101

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives