Abstract:
Introduction: HIV/AIDS incidence continues to rise in many developing countries, and the development of effective prevention efforts is challenged by limited data on the social and cultural factors that influence sexual risk behaviors. In Sri Lanka, the lack of reliable data on the sexual health behaviors of youth presents a major challenge to HIV prevention workers. Method: A cross sectional survey of a representative sample of youth attending university entrance classes in Sri Lanka was conducted to identify their sexual health behaviors and the socio-ecological factors that challenge the development of sexual health programs. Results: A total of 1,401 students (48% males and 52% females) between the ages of 18 � 21 participated. Sexual intercourse was reported by 11.7% of males and 2.2% of females (Z=6.60, P< 0.05) and 13.2% of males and 0.9% of females reported that they had participated in anal sex (Z=9.004, p< 0.05). Only 39.1% of those reporting vaginal sex and 29.1% of those reporting anal sex indicated they had ever used a condom. Major socio-ecological constraints to program development included: a) teacher�s and parent�s disapproval of sexual health programs, b) cost of, and limited access to, condoms, and c) non-availability of student health counselors. Conclusions: Youth in Sri Lanka are participating in HIV risk behaviors; this study is representative of those needed to better document these behaviors and their correlates. In addition to research, collaboration between parents and health professionals will be necessary to address the social and ecological challenges of HIV prevention program development.
