WESTMORELAND ADOLESCENT 
REPRODUCTIVE HEALTH: 
AN EVALUATION OF YOUTH.NOW’S 
PEER EDUCATOR / PEER LINK INTERVENTION 
WESTMORELAND ADOLESCENT 
REPRODUCTIVE HEALTH: 
AN EVALUATION OF YOUTH.NOW’S 
PEER EDUCATOR / PEER LINK INTERVENTION 
Herbert Gayle 
School of Oriental and African Studies 
University of London, UK 
July 2004 
This evaluation was made possible through support provided by US Agency for International 
development, Jamaica Mission under Contract No. 532-C-00-00-00003-00. The opinions 
expressed are those of the author and do not necessarily reflect/ represent those of the US 
Agency for International Development. 
ii 
RESEARCH TEAM 
Herbert Gayle 
Andrew Grant 
Dorraine Parks 
Kerry-Ann Samuels 
Kadene McPherson 
Anastasia Whyte 
Kemesha Reynolds 
Richard Pasley 
Dave Noel Williams 
Taniesha Nelson 
Sherrian Gray 
Cherine Richards 
Tova Trench 
Michelle Ambersley 
iii 
ACKNOWLEDGEMENTS 
This study would not have been possible without the support, dedication, and hard work of a 
number of individuals, groups, and organisations. We wish to express our most sincere gratitude 
to all those instrumental in the inception and creation of the study, those who gathered relevant 
data, the respondents, and all whose support and work ensured the successful completion of the 
study. 
Special thanks must first be extended to the adolescents who allowed us to enter into the intimate 
details of their lives, allowing us to encroach upon their valuable time for more than an hour in 
many cases. We must also make special mention of the peer educators who helped us, some on 
multiple occasions, to locate their network, camp attendees, and even controls in their 
communities. Since this was an enquiry among children, permission had to be obtained from 
parents and school administrators, and we sometimes had to get the blessings of enquiring 
community members. We are grateful for their enthusiastic approval and for allowing us the 
privacy we needed to conduct interviews. 
Lastly, a special word of thanks must be reserved for Pauline Russell-Brown and her team at 
Youth.now for allowing us the joy of investigating, recording, and telling this story. We hope to 
have done justice to the programme and the youth involved. 
iv 
Table of Contents 
Chapter 1: Introduction.....................................................................................................1 
Chapter 2: System of Support ...........................................................................................5 
Chapter 3: Recruitment and Selection ............................................................................12 
Chapter 4: Peer Educators and Their Network ...............................................................17 
Chapter 5: Impact of the Intervention.............................................................................23 
Chapter 6: Some Pointers................................................................................................40 
Appendix: The Instrument ..............................................................................................43 
v 
CHAPTER ONE 
Introduction 
Background 
In 2003, Youth.now executed a series of one-week training camps in Westmoreland in its 
continued quest to empower youth to better manage their reproductive health. Westmoreland is 
one of the poorest parishes in Jamaica, with its poverty-related problems having been 
documented for the past three-quarters of a century. The economy depends largely on tourism, in 
Negril, farming and fishing. Although it boasts the largest proportion of arable land in sugar 
cane, structurally, not much has changed in the parish’s economy since the 1930s riots at Frome, 
where the country’s largest sugar factory is located. However, Westmoreland is fast urbanizing. 
Today it has three significant urban centres: Savanna-La-Mar, the capital; Negril, the tourism 
centre; and Grange Hill, a sugar-belt community urbanized within the past decade. 
When an area rapidly urbanizes without comparable economic expansion, one result is a larger 
proportion of the population becoming poor and frustrated. And so, although the parish is 
labelled “rural,” one can find organized gangs, obvious prostitution, and crack cocaine addicts 
competing to wash cars throughout the area. Westmoreland has thus become a social concern. 
In April and July of 2003, 261 adolescents were trained in what Youth.now referred to as Peer 
Links camps. The overwhelming majority (over 240) came from Westmoreland. Of this number, 
a cadre of 60 received further training in leadership skills and methods of disseminating 
information. These adolescent peer educators were organized into a number of geo-social 
networks. Whilst encouraged to communicate and work with the team, each person was given 
the autonomy to create his or her own sub-network inclusive of family, friends, churches, clubs, 
or corner crews. Undoubtedly this approach is futuristic, as it appeals to the need in adolescents 
to be considered responsible enough to manage and to do so within their own invented frames. It 
is expected to be successful on the grounds that teenagers and young adults spend more time on 
the street than other groups. They are therefore more aware of the occurrences at the grassroots 
level. Even more important is the fact that these groups are the most fertile and most affected by 
the threatening crisis of HIV. 
The peer educator approach is unquestionably powerful. Nonetheless, the success of any project 
relies not only on the creativity and soundness of its construction, but also on its management. 
Futhermore, a project must negotiate the series of threats or militating factors as well as 
opportunities or facilitating factors operating within the environment where the intervention is 
targeted. Interestingly, social environments are dynamic and have the capacity to change rapidly. 
It is therefore critical to assess a target environment continually, inclusive of the reflexivity of 
those who try to intervene. 
The rationale for project evaluation is obvious. We appreciate the fact that Youth.now decided to 
pause and view the social facts of the project—that is evaluate from an outside or independent 
position—which is accomplished through this consultancy. 
1 
Objective 
To assess the impact of Youth.now’s Adolescent Reproductive Health peer counsellor training 
intervention in Westmoreland and to provide information that will inform its strategy for 
continued interventions. The specific objectives are as follows: 
1. To assess the extent to which the training carried out by Youth.now impacted the youth 
participants’ knowledge, attitude, and to a lesser extent, behaviour in regards to 
reproductive health. 
2. To map the development and success of the networks created by Youth.now’s trained 
leaders by roughly calculating the number of adolescents and young adults reached at the 
primary and secondary levels of impact. 
3. To assess the quality of the transfer of knowledge from the peer educators to other youth 
and to detail the factors that impact on such transference. 
4. To present to Youth.now a series of recommendations to inform its strategies for 
continued youth intervention in reproductive health. 
Methodology 
The main focus of the evaluation was a retrospective examination of the intervention, but with a 
control against which to compare those affected by the intervention. Social research is based on 
‘Best Bets’ since it is the changing world that is the ‘laboratory’. This evaluation, therefore, 
could have been done in several ways; but given the absence of a baseline, a comparative-tracer 
design seemed especially advantageous. This involved the use of a “control,” or group that was 
not impacted by Youth.now’s intervention. The control was drawn from the “proximity,” or 
within the locale of Westmoreland, based on geo-social settings: inner city, semi-urban, and so 
forth. This approach is quite popular and has been used in both quantitative and qualitative 
research studies. The single concern in using this methodology is the fact that sometimes “close 
proximity controls” pick up out-layers that were affected at secondary and tertiary levels by the 
intervention. This risk was reduced drastically by studying the majority of the intervention group 
and by evaluating a trace of the primary and secondary impact of the networks formed. 
Data Collection 
The evaluation made use of Participatory Learning and Action (PLA) tools. Over the past two 
decades the divide between qualitative and quantitative has narrowed tremendously as social 
scientists have come to recognize the benefits of integrating or mixing aspects of both 
methodologies. This evaluation utilized a standardized integrated instrument to guide the 
interviews. This means that the questions reflected both qualitative and quantitative research 
positions, thus increasing the possibilities of exploration, as well as allowing for statistical 
inferences. The questions were guided by the areas or themes covered in the training carried out 
by Youth.now and were matched against instruments previously used by other groups, such as 
Children First, working with adolescents. They focussed on knowledge, attitude, and to a lesser 
extent (due to the short interval between intervention and measurement), change of behaviour. 
Sample
Four cohorts of adolescents were interviewed: peer educators, network, peer links, and control. 
Each group was further divided into age categories: 10-13, 14-16, and 17-19. The 17-19 age 
2 
group was too small to generate a sample equivalent to the other two age groups. The emphasis 
in the training also seemed to have been on the two younger groups and had to be reflected in the 
sample, which aims to be proportional. An attempt was also made to have equal proportions of 
males and females. 
Sixty adolescents were trained as peer educators. Each peer educator was expected to create a 
network of persons whose knowledge base, attitude, and behaviour in the area of reproductive 
health would have been affected. Each of these youth supplied the team with details of all the 
work done: family, friends, clubs included. These were then tallied to produce the sum total of 
their impact in the parish. Forty-seven peer educators were found; and a corresponding 47 
network persons were interviewed. This is not to suggest that each peer educator produced one 
network person to be interviewed. The reality is that many of the peer educators’ networks could 
not be accessed, as they were at school doing various examinations or were too far away to be 
interviewed. As a result, those whose networks were available yielded enough to create a 
balance. One person who had formed a club produced as many as seven network respondents; a 
few others had three available. Most networks were primary (spoken to directly by the peer 
educator) but there were also four secondary and two tertiary networks (persons who were 
spoken to by persons already spoken to by a peer educator). 
Unlike the peer educator group where almost all were traced, 52 (just under a third) of the 180 
Peer Links youth who attended one of the two camps held April and July of 2003, but did not 
attend the Peer Educator camp held in August, were interviewed. The control group consisted of 
52 persons who were not affected by the networks or peer links adolescents of Youth.now. Each 
person selected for the control was questioned prior to the interview to ensure that this was so. 
All peer links-trained youth were systematically matched geo-socially by controls to factor out 
the direct impact of intervening variables of class, age, gender, and experience. 
Observation and Confidence 
The research team relied heavily on observation to verify the data respondents gave in response 
to the instrument. Most interviews were carried out in the home, and when that was not possible, 
in the community where the respondent resides. Forty-seven (78 percent) of the 60 peer 
educators were interviewed. The team visited the home of another nine, though the peer 
educators were not available to be interviewed. In other words, only four peer educators were not 
contacted or their family background noted. Given the size of the sample and the depth of 
investigation, we feel confident that the information on peer educators is extremely accurate. 
More than a half of the adolescents who participated in the Peer Links training were visited— 
though the team needed only a quota of 50. Many of these adolescents were not available on 
request. In many cases, team members were expected to return but found other persons to 
interview and hence apologised for not returning. This fate, taken as a stressful aspect of the task 
by some team members, helped to increase the confidence level of the data, as it allowed team 
members to observe the environment of a larger proportion of the Peer Links-trained adolescents. 
In summary, 198 adolescents were interviewed for the purpose of assessing the impact of the 
programme carried out by Youth.now and to help inform the project’s way forward. The 
qualitative details helped to point out the programme’s strengths and weaknesses, opportunities 
3 
that can be maximized, and challenges within particular environments to tackle. The study 
sample is represented in Table 1.1 below. 
Table 1.1:Sample Distribution 
Groups 
10 – 13 14 – 16 17 – 19+ 
Target Count Target Count Target Count 
M F M F M F M F M F M F 
Peer Ed 44 47 8 8 8 8 8 10 8 11 5 5 7 5 
Network 44 47 8 8 8 8 8 10 10 10 5 5 5 6 
Standard 50 52 10 10 10 10 10 10 10 11 5 5 5 6 
Control 50 52 10 10 10 10 10 10 10 11 5 5 5 6 
TOTAL 188 198 36 36 36 36 36 40 38 43 20 20 22 23 
Analysis 
The sample was divided into four groups, which was subdivided by age, gender, and geo-social 
situations. These divisions helped to identify the factors that determine success, failure, or that 
intervene to create unexpected results. Tables and graphs are used to display results. Scores were 
given to the responses on each instrument. These scores were used to assess the impact of the 
intervention and were modelled against a “perfect impact” frame in which the peer educator 
cohort should have highest scores, followed by the Peer Links-trained adolescents, the network 
or “affected,” and last, the control or “unaffected.” Deviations from this pattern were noted to 
produce the determinant factors and or fault lines within the intervention. 
4 
CHAPTER TWO 
The System of Support for Respondents 
This chapter assesses the quality of respondents’ emotional, social and economic support 
systems. It includes a brief examination of the sources from which adolescents get information 
on matters of reproductive health. 
Parents and Guardians 
As represented in Table 2.1, fathers and mothers account for the majority of heads of households 
among those adolescents interviewed. Forty percent said their fathers are the head of household, 
and 28 percent said their mother is the head of household. This is followed by grandparents, at 
18 percent, and other family members, including step-parents, siblings, and godparents. Notice 
that six of the adolescents were on their own (self or partner head). Three were below the age of 
16, including a 15-year-old who lived with her 29-year-old man and his mother. All are from 
inner city settings, yet another reason to pay special attention to the inner city in future 
interventions. 
Table 2.1: Heads of Household 
Heads of Household Number 
Father 80 
Mother 56 
Grandparents 35 
Aunt/Uncle 11 
Step-parents 5 
Self 4 
Sibling 3 
Partner 2 
Godparents 2 
TOTAL 198 
Fathers 
Fathers were present in 43 percent of households (Table 2.2). In those households where the 
father is present, 95 percent (80 of 84) were considered to be the head of the household (Table 
2.1). The data suggest that father is the authority figure once he is present but there are important 
exceptions. In four cases, the fathers were unemployed or marginally employed, though present 
in the home. In other cases, even though the father was present the mother was presented as head 
of the home by the adolescents. Therefore, the father’s role is primarily financial. 
Table 2.2: Father Presence by Socio-economic Background 
Socio-economic Father Presence 
Background Total Yes No 
Suburban 13 8 5 
Urban Lower Middle 26 15 11 
Semi-urban Lower Middle 15 7 8 
Urban Working Class 26 6 20 
Inner City 42 19 23 
Semi-urban Working Class 66 25 41 
Rural Poor 10 4 6 
5 
TOTAL 198 84 114 
Table 2.3 suggests that whether father is inside the home or not makes very little difference in 
terms of whether or not he will be perceived as a source of emotional support. Of the 84 fathers 
present in the home, respondents only ranked 25% first or second in terms of closeness. Of 
fathers outside the household, 28 of 114 (25%) were ranked first and second in terms of 
closeness to the respondents. Although more boys than girls expressed closeness to their fathers 
(30 of 49), most adolescents, despite gender, were closer to their mother than their father. There 
is obvious need for programmes that will educate members of the household that fathers have 
important roles other than economic in the lives of adolescents. 
Table 2.3: Parents Ranked First and Second in Terms of Closeness to Respondents 
Parents Location Re Household Total Proportion 
Inside Outside of N (198) 
Father 21 (25%) 28 (25%) 49 25% 
Mother 112 (69%) 11 (31%) 123 62% 
The presence of fathers in the home was greatly affected by socio-economic situation. Table 2.2 
and Figure 2.1 show that adolescents from poor backgrounds were more likely to live without 
their fathers present in the home. 
Figure 2.1: 
Father Presence 
0 
5 
10 
15 
20 
25 
30 
35 
40 
45 
Number of Presence or 
Absence 
Father Presence Yes 
Father Presence No 
Suburban Urban Semi-urban Urban Inner City Semi-urban Rural Poor 
Lower Lower Working Working 
Middle Middle Class Class 
Socio-economic Background 
Table 2.4 and figure 2.2 further illustrate that fathers who are absent from non-poor households 
are more likely to be accounted for than those of poor households. In other words, they are more 
likely to be involved in their children’s life when absent from the home than their poor 
6 
counterparts. In the data displayed below all “abroad” and “local” fathers support their children 
financially and to some extent emotionally. The others were either dead or not involved in the 
lives of their children. Interestingly, all five suburban fathers absent during the evaluation were 
overseas and only one did not call his child at least weekly. What was encouraging was the fact 
that for all groups there were either equal number of or more absent fathers supporting their 
children than those not involved. 
Table 2.4: Accounting for Absent Fathers 
Socio-economic Background Father Status 
Abroad Local Dead Not Involved 
Suburban (5) 5 0 0 0 
Urban Lower Middle (11) 2 6 0 3 
Semi-urban Lower Middle (8) 4 1 3 0 
Urban Working Class (20) 5 9 0 6 
Inner City (23) 2 9 1 11 
Semi-urban Working Class (41) 6 15 0 20 
Rural Poor (6) 0 3 0 3 
TOTAL (114) 24 43 4 43 
Figure 2.2: 
Accounting for Absent Fathers 
20 
18 
16 
14 
12 
Number of Fathers 10 
8 
6 
4 
2 
0 
l 
l
Father Status Abroad 
Father Status Loca
Father Status Dead 
Father Status Not Invo ved 
Suburban Urban Semi-urban Urban Inner City Semi-urban Rural Poor 
Lower Lower Working Working 
Middle Middle Class Class 
Socio-economic Background 
It would serve Youth.now well to target fathers in their efforts to help children. The data show 
that many fathers are excluded due to their responsibility to provide financially for the 
household. Many have to earn abroad, and there is also evidence of others who were forced to 
leave because of unemployment. The issue of the father’s power within the home cannot be 
taken for granted. Two boys felt so strongly about their fathers they listed him as head of the 
household although the fathers were abroad for years. Though physically absent, some fathers 
7 
maintained good relationships with their sons, speaking with their sons every other day and 
taking time out to discuss matters of reproductive health. Nonetheless, a critical find is that many 
boys felt their masculinity threatened by the absence of a father in the home. Many were 
obviously embarrassed to say that their mother was head of the home. Whilst the impact of the 
father’s absence on the emotional health of the youth is not as obvious as that of mother’s 
absence, his presence is critical to the full health of the adolescent. It would be an excellent 
intervention to provide information to youth to take to their fathers and to assess the knowledge 
base of these fathers after a period, before and after that intervention. 
Mothers 
Most respondents identified their mothers as primary nurturers, though 36 respondents identified 
their mothers as being outside the household. It should be noted that 69 percent of the 162 
mothers who were inside the household were listed as having a close relationship with the 
adolescent. However, mothers were not seen as a nurturer once she left the household. Only 31 
percent of mothers who were outside the household were seen as a friend. Girls were most 
hostile to the absent mother. Only the mothers who were overseas (nine, including four with 
father abroad) seemed to receive some degree of forgiveness. It seemed then that a mother’s 
absence from the home, despite the contribution of the extended family, had a negative impact 
on the emotional stability of adolescents, especially girls. At least five girls described their 
mothers as being less than a mother for leaving. Words such as: “horrible,” ”selfish,” and even 
“bitch’ were used to describe the absent mother. She received no forgiveness from the three girls 
and one boy who were left with their fathers alone. 
Grandparents 
Grandparents were found to be critical in the matter of power and emotional stability within the 
household. In the absence of fathers, grandparents often become the head, especially if mother is 
young and still resides in the home of her parents. There were 16 such cases. In most cases where 
the mother was absent and grandparents served as the guardians, the children expressed that they 
were closer to their grand parents than the absent mother. Twenty-six respondents listed 
grandparents as first or second closest person in the household. There is one major drawback 
with having grandparents as guardians: the generation gap often means the grandparents do not 
serve as good sources of information on matters of reproductive health. 
Sources of Information on Sex and Family Life 
The data collected on “Sources of Information on Sex and Family Life,” displayed in Tables 2.5 
and 2.6, explicitly present Youth.now as a substitute for parents in providing information on 
reproductive health. Irrespective of socio-economic background, Peer Links-trained adolescents 
and peer educators presented Youth.now as their primary source of information on adolescent 
reproductive health. Only eight persons gave the quality of the information received at camp a 
less than perfect score. Of this number, only two actually rated the quality “average” (5-7 out of 
10). The other six respondents felt they had been so exposed prior to attending the camp that it 
served more as a reminder than a source of new information, and gave scores of 8 and 9 out of 
10. Guidance counsellors were selected as the next most important source of quality information 
on matters of adolescent reproductive health. This was without variation across gender and 
socio-economic background. 
8 
Not surprisingly, girls gave parents a slightly higher ranking to parents as a quality source of 
reproductive health information and presented them as being more important than television. 
Boys felt that their television programmes were a marginally better source of information. What 
is tragic here is the fact the despite the quality programmes presented on television, including 
those of Youth.now, the set is highly non-interactive. The point is that if parents were educated 
to the importance of their task and if they were given the confidence to counsel their adolescent, 
they would not have to compete with the television as a source of information on matters of 
reproductive health. It was embarrassing to hear youth explaining how they “packed” their 
parents and sent them off to the Parent seminar held by Youth.now in Savanna-La-Mar at 
Commingle Hotel to ensure that they would not tell the adolescent “bulls” when they knew 
better. Many youth complained of their parents’ ignorance. Some parents also confessed to 
reading the information the Peer Links-trained adolescents and peer educators brought back from 
camp, “But when them gone to sleep, for it kind of embarrassing for him to know I just learning 
these things.” 
Most parents were under the age of 45 and therefore are themselves still very prone to HIV as 
they produce more children. The task to address reproductive health of adolescents must 
therefore include parents in a holistic manner—sick parents cannot raise children. Parents should 
be targeted not only for how they can improve the healthy growth of their children, but also for 
their own sexual and reproductive health. 
9 
Table 2.5:Sources of Information on Sex and Family Life: Males Ranking Averages 2 
RATINGS 
8 to 10 5 to 7 1 to 4 
Peer Ed
Network
Peer
Links
Control
Peer Ed
Network
Peer
Links
Control
Peer Ed
Network
Peer
Links
Control 
Doctor 7th 11, 1, 3 11 8 14 9 1 0 1 0 1 4 4 4 
Nurse 5th 12, 1, 2 12 12 17 7 1 0 1 1 1 3 0 4 
Clinic 6th 11, 2, 3 15 8 14 7 2 1 3 0 1 3 2 5 
Guidance Counsellor 2nd 17, 2, 2 21 15 18 15 1 2 0 4 0 2 2 2 
Class Teacher 8th 10, 5, 3 8 9 14 10 6 2 3 7 4 4 1 1 
Youth.now Camp 1st 26, 0, 0 23 X 22 X 0 X 1 X 0 X 0 X 
Parents 4th 14, 3, 3 10 16 13 17 4 3 3 1 5 4 0 1 
Grandparents 11th 8, 2, 3 5 9 8 9 3 1 3 1 3 4 2 2 
Guardian: Non Relative 15th 6, 3, 3 6 7 6 4 1 3 2 4 2 1 5 3 
Public Forum 14th 6, 4, 4 6 6 8 3 3 3 5 3 3 4 4 5 
Television 3rd 14, 6, 2 13 15 11 15 7 5 6 4 2 1 2 1 
Cable 13th 6, 5, 3 7 5 9 4 7 5 3 3 1 3 6 3 
Internet 17th 5, 3, 3 6 3 7 3 3 3 0 5 4 3 3 1 
Friends 9th 10, 5, 4 12 8 7 11 4 6 5 3 4 3 4 6 
Community Leader 18th 4, 4, 4 4 3 5 2 3 3 7 3 3 5 3 4 
Church Leader/Pastor 12th 8, 2, 4 9 7 9 6 2 1 4 1 2 6 3 3 
Sibling 10th 8, 4, 5 8 6 9 7 2 2 4 3 4 5 7 5 
On the Street 16th 6, 2, 6 3 4 3 6 5 3 7 7 9 7 4 4 
1
 Averages are the mean number of respondents whose rankings for the source fell in the respective categories. 2
 Averages are the mean number of respondents whose rankings for the source fell in the respective categories. 
10 
Table 2.6: Sources of Information on Sex and Family Life: Females Ranking Averages 4 
RATINGS 
8 to 10 5 to 7 1 to 4 
Peer Ed
Network
Peer
Links
Control
Peer Ed
Network
Peer
Links
Control
Peer Ed
Network
Peer
Links
Control 
Doctor 6th 14, 1, 4 16 14 12 12 1 2 1 0 4 3 3 6 
Nurse 9th 12, 4, 3 15 13 10 11 4 4 1 2 3 2 4 4 
Clinic 5th 14, 2, 4 17 14 12 14 3 2 1 2 1 4 4 5 
Guidance Counsellor 2nd 19, 2, 2 17 19 19 19 2 3 1 2 3 0 2 4 
Class Teacher 7th 13, 7, 4 10 13 12 15 10 3 7 6 2 7 4 4 
Youth.now Camp 1st 24, 0, 0 24 X 23 X 0 X 1 X 0 X 0 X 
Parents 3rd 18, 3, 4 20 15 18 18 2 3 4 2 2 5 2 5 
Grandparents 10th 9, 3, 7 4 12 8 10 4 2 3 3 10 8 7 4 
Guardian: non relative 11th 9, 2, 4 9 10 8 9 4 2 0 1 3 4 5 3 
Public Forum 13th 8, 4, 5 9 9 7 5 7 3 2 3 3 6 4 6 
Television 4th 15, 6, 3 15 14 14 16 6 5 6 6 3 3 2 2 
Cable 15th 7, 4, 4 7 8 7 7 7 3 3 3 5 3 2 4 
Internet 17th 6, 2, 4 7 5 6 5 2 3 0 1 4 5 4 4 
Friends 8th 12, 7, 3 9 11 14 12 10 5 7 6 2 4 1 4 
Community Leader 18th 3, 3, 5 3 6 3 0 1 2 4 4 8 3 3 5 
Church Leader/Pastor 14th 8, 3, 5 10 10 8 4 4 3 2 3 7 5 4 5 
Sibling 12th 8, 4, 4 8 10 7 5 6 4 4 2 5 6 2 4 
On the Street 16th 7, 4, 8 6 8 7 7 3 3 7 4 10 11 3 6 
3
 Averages are the mean number of respondents whose rankings for the source fell in the respective categories. 4
 Averages are the mean number of respondents whose rankings for the source fell in the respective categories. 
11 
CHAPTER THREE 
Recruitment and Selection 
Many of the youth who went to the Youth.now Peer Links camps were, in fact, in trouble. Their 
parents begged the Parish Coordinator to take them “…expecting a miracle…and thanks Jesus 
my prayers came through.” The testimonies of parents were quite telling in some instances. 
Parents and neighbours even reported that their sons went to camp with guns (2) and knives (7). 
All these cases were verified with the boys and found to be true. Camp for them was expected to 
be a place to “stab up the bwoy,” but turned out to be a place where they became friends and 
came home to help dismantle the gang in Savanna-La-Mar they once took as their space. 
Method of Recruitment 
Adolescents were recruited to the Peer Links camps through a Youth.now network of links in 
Westmoreland and also by open invitation. A large number of youth were invited to camp 
through the network of Youth.now’s Parish Coordinator, who is located at the parish’s major 
clinic in Savanna-La-Mar. The Parish Coordinator then asked clinic staff to find adolescents in 
their communities who they felt needed “to attend a camp where they will teach them about 
family life issues and sex.” Other clinic staff were asked to act as facilitators. The Parish 
Coordinator also recruited persons involved in other community services (including community 
leaders and/or managers of CBOs) and those involved in the gathering of parish data (such as 
working for STATIN) to assist in the process. Furthermore, schools served as a pool for 
recruitment. There was also a public forum held in the capital town where adolescent 
reproductive health was highlighted and adolescents were given an open invitation to attend the 
Peer Links camps. As a result, far more youth were recruited than could be accepted at camp. In 
addition, these youth were brought together in a very short time; some ready for camp just a few 
days after being informed by their community leader or “the lady at the clinic.” 
The way in which the youth were recruited can be described as convenient, inexpensive, and 
largely effective. It is laudable that existing networks were used to recruit the youth to camp. 
Forming new networks would have been expensive and might not have been as effective. Much 
of the success of the recruiting process depended on the personal concerns of health workers and 
community leaders facilitating the process. Clearly many of them recruited youth who they 
strongly felt were “on the road to perdition;” others because they are bright and could come back 
and help those on the hell-bent Road. Many of the youth interviewed confessed they were known 
in the community to be quite vulnerable to contracting HIV due to their behaviour: “The lady say 
me need to go.” 
The obvious problem with the methodology is that they did not recruit a stratified sample of the 
parish proportionately or by means of a needs assessment. The idea here is not to devalue the 
impact of the personal concerns of the facilitators that drove the process. In fact, we recommend 
that this network be kept in place. Nonetheless, in future it would be helpful if the process 
involves more structure. We recommend that an index of the social and health services of the 
entire parish is taken with the aim to recruit from all areas, focussing on those areas with greatest 
12 
needs. Facilitators and trainees commented that some areas were not represented or not 
represented well. 
Representation by Background 
The matter of social background was treated as a critical intervening variable. Assisted by 
observation, the first three pages of the evaluation instrument largely determined the 
respondents’ socio-economic status. The first table describes household size and economic 
activity, the second table speaks to quality of life, and the third relates to the neighbourhood in 
which the respondents live. Socio-economic background is known to have direct impact on the 
sexual behaviour of youth (see Chevannes and Gayle, 2000: the PAHO Study). The usual trend 
is that the poorer and more urban, the more vulnerable an adolescent is to HIV, since the urban 
and rural poor begin to have sexual intercourse earlier than other groups and are usually less 
informed. The relevant question here is to what extent were the urban poor (especially inner city) 
targeted in the recruitment process; and what proportion were included in the elite group of peer 
educators to further network this vulnerable group. 
It would seem that in terms of the recruitment of Peer Links, the process went commendably 
well. There were only a few noticeable weaknesses. Table 3.1 shows the largest single socio￾economic group in the parish is semi-urban working class, comprising almost a half the parish. 
About 40 percent of the youth recruited to camp were from this group (33% of sample). 
According to a statistician in the parish, the second largest group is the urban poor (working and 
inner city). A third of the parish can be described as urban poor, corresponding perfectly to the 
one of three recruited to camp (34% of sample). It is praiseworthy that the emphasis here was on 
recruiting those from inner city background (19 of the 34). 
13 
5 
Table 3.1: Socio-Economic Background of Recruits5
 PEER 
EDUCATORS 
PEER LINKS ALL LINKS PROPORTIONS 
ELECTED 
Suburban 8 1 9 89% 
Semi-urban Lower Middle 6 2 8 75% 
Urban Lower Middle 5 6 11 45% 
NON-POOR SUB-TOTAL 19 9 28 68% 
Urban Working 12 3 15 80% 
Semi-urban Poor 11 22 33 33% 
Inner City 3 16 19 16% 
Rural Poor 2 2 4 50% 
POOR SUB-TOTAL 28 43 71 39% 
TOTAL 47 52 99 NA 
Very early in the fieldwork, team members noticed a weakness in the proportion: the non-poor 
(including near poor or lower middle class) were over represented. Team members immediately 
began to ask if the youth were stratified by socio-economic background. They are over 
represented because they make up less than a quarter of this poor parish, but more than a quarter 
of the recruited were suburban and lower middle class (28%). However it is the fact that they are 
The respondents were divided into seven useful socio-economic groups: 
1. Suburban refers to persons who are clearly middle to upper class. Nine such adolescents were interviewed, 
including one upper class and two upper middle. All three wealthy respondents came from the traditional 
merchant class of the parish. However, the parents of one (upper class) have the power to affect the 
political base of the parish. Most of these adolescents came from Ferris, Amity, Grove and enclaves in 
Smithfield. The children exclusively attend Mannings or boarding and traditional schools in St. James and 
St. Elizabeth. 
2. The semi-urban lower middle is located just beyond the suburban (within a five-mile radius of a major 
town. They are economically similar to the urban emerging class but their children are not as affected by 
the problems of urban life. Most of the people of Shewsbury, Georges Plain, and Smithfield fit this profile. 
3. The urban lower middle are located close to the urban poor in Savanna-La-Mar and are affected by the 
happenings in the neighbourhood, but are near-poor rather than poor. They are fairly economically stable 
and can afford to have computers (and most times internet), washing machines and a vehicle, and the 
children do not share beds. 
4. The urban working class is poor but lives in areas where there remains a strong sense of community and 
violence is relatively low or controlled. Parents are not professionals or entrepreneurs and often only one 
person is fully employed and/or the father is absent. Most of Savanna-La-Mar, Grange Hill, and Negril fit 
this profile. 
5. Semi-urban poor are the most fortunate poor traditionally in terms of parent and community support. In 
terms of father presence or access to information, they have not been at an advantage in this study. In 
Westmoreland, most of these respondents came from the sugar-belt areas. Violence is occasional in these 
communities. Nonetheless sex begins relatively early and children are often burdened with adult-type work 
to help family survive. 
6. The inner city has the most vulnerable children. There are cases where no one is fully employed. Children 
share bed in almost all cases. The third table on the instrument shows a high degree of violence (including 
rape, shooting, and the burning of neighbour’s houses). There is also evidence of constant conflict between 
neighbours. Russia, Shaolin Temple, Cooke Street, and parts of Desta and Seaton Crescent fit this profile. 
7. Rural poor here are treated as those few whose parents depend largely on agriculture. These respondents 
are situated at least 10 miles from a major town. The few rural communities left in Westmoreland are quiet 
and visits to the town by relatives are periodic. No community on the Georges Plain is considered rural 
today in this rapidly urbanising parish; Cave Mountain, Beeston Spring, Petersvale are among these 
communities, all located in the hills. 
14 
the least vulnerable that is the critical reason that this group could have been smaller in the 
recruited. 
Rural communities are being transformed rapidly and hence were but few. Checking addresses, 
only less than five percent of the recruits came from the mountainous rural communities. If we 
take the statistician’s estimate that about 10 percent of the parish still remains purely rural, then 
the rural communities were poorly represented. To some extent this is understandable, given the 
distance, lack of telephones, and uncertainty of finding youth when needed. Nonetheless, had a 
stratified sampling technique been employed, the recruiters would have been forced to find more 
rural poor. The research team found it problematic to sample the few rural youth. In fact, only 
four were found. Telephone numbers turned out to be that of someone working in the town, or a 
neighbour, or they belonged to the health clinic in Savanna-La-Mar. It was also quite heart￾rending to drive for over 10 miles to find a child only to hear that, “Him just gone bush wid him 
brother.” 
One important urban area seemed to have been forgotten: Negril. It was, in fact, noted by the 
facilitators we met. Very few youth came from that area, although it is a large area with 
significant adolescent health concerns, given the involvement of adolescents there in the thriving 
sex industry. As one facilitator pointed out, “Many of the youth who work in Negril are actually 
from Savanna-La-Mar or Grange Hill and other surrounding areas, but a lot of youth actually live 
in the Negril area, such as Red Grounds. I don’t see them on your list and that is a problem area.” 
Overall, the recruitment of Peer Links seemed to have been quite balanced. Where there were 
weaknesses, they were not drastic. Nonetheless, we recommend that a stratified sample is taken 
in the future, mixed with a needs approach, thus increasing the number for inner city and rural 
slightly above parish proportion. 
The near-balance witnessed in the recruitment of Peer Links was lost in the selection of peer 
educators. It seems the recruiters were very human in this regard. They selected the brighter, 
more-friendly, more confident, natural born leaders to be peer educators. None of the gang 
members, none of those who took knifes to camp, or just went “to look gal” were selected. There 
was one exception to the rule: one peer educator could not read. This was probably by default 
rather than design. Clearly the attractive leader quality type selected makes sense. The data 
shows clearly that the attractive youth selected were effective as peer educators. The imbalance 
in terms of socio-economics was, however, so drastic that one was forced to ask if more would 
not have been achieved if a balance was attempted, as was evidenced in the recruitment of Peer 
Links. Sixty-eight percent (19 of 28) of the non-poor were selected as peer educators, compared 
to thirty-nine percent of the poor (28 of 71). The most noticeable imbalance is between inner city 
(only 16%) and suburban (89%). Obviously, the urban working class (80%) was preferred to the 
less confident inner city youth whose behaviour is less likely to be competitively attractive. 
Undoubtedly, this method is flawed if the intervention rests on the power of peer education. It is 
fair to say that inner city youth are more effective in transferring information to their inner city 
peers than any other group, especially bright, uptown youth reaching down to them. This was 
arguably the most obvious weakness in the recruitment and selection process. More inner city 
youth should have been selected into the elite group because of their potential to penetrate their 
15 
own target group—despite their lack in leadership skills and less attractive behaviour. In other 
words, the recruiters could have gambled more on the less attractive trainees who had greater 
access to the most vulnerable. In fact, the Peer Links from urban poor background competed 
strongly by networking a large number of persons, almost as if they were peer educators. This 
can be treated as proof that a youth can be an effective peer educator without attractive 
personalities or background. This is not to suggest that he will reach as many as the elite 
selected. The data does not support this—only that a balance would have helped to target more 
of the more vulnerable. 
Education Performance 
Adolescents’ education performance is an important factor in their ability to learn and 
disseminate information related to reproductive health. The research team documented the best 
and worst grades respondents reported they received in school. The average was found and 
categories of “outstanding” (80-100%), “above average” (60-79%), “average” (40-59%), and 
“below average” (0-39%) used to describe respondents’ performance. Table 3.2 shows that 
generally two-thirds of the respondents reported being above average or outstanding. Only peer 
educators departed from this trend with 81 percent outstanding or above average. This could be 
taken as a deliberate effort to select the brighter or higher performing students into the elite peer 
educator group. As the team recognised during the fieldwork, these respondents would have been 
identified easily as the more confident of the Peer Links. The problem, though, is that the 
brighter, more confident youth were disproportionately non-poor. 
Table 3.2: Academic Performance by Groups 
Outstanding Above 
Average 
Above and 
Outstanding 
Average Below 
Average 
Peer Educators (47) 4 34 81% 6 3 
Peer Links (52) 6 29 67% 12 5 
Networks (47) 4 25 62% 14 4 
Control (52) 6 28 65% 14 4 
16 
CHAPTER FOUR 
Peer Educators and Their Network 
Forty-seven peer educators of various socio-economic background produced networks of 1,674 
persons. This means that on average each person trained as a peer educator can be expected to 
produce a network of over 36 youth or peers. This is only at the primary level. Tracing the 
networks of three peer educators, it was found that of every four persons reached by a peer 
educator, one, or 25 percent, can be expected to carry on transmitting the information fairly 
accurately. This is especially true since most peer educators went to the extent of even 
photocopying their pamphlets to ensure that their network people were well equipped. It was 
found that each person in this 25 percent reached at least two persons. This would mean another 
800 persons were impacted. In other words, though the information transmitted lost some degree 
of quality, the impact at the secondary level is half as extensive as at the primary. 
Whilst we could not assess as accurately the impact at the tertiary level, it is fair to say that this 
level cannot be ignored. The serendipitous experience here is the fact that the Peer Links who did 
not receive as extensive training as the peer educators produced networks 70 percent as 
extensive. Twenty Peer Links were traced. It was found that they produced an average of 25 
persons in their networks. This finding would suggest that overall the Peer Links programme has 
the ability to produce more networks, as it involves far more youth (261 compared to 60 
specially trained peer educators). It is important to note, however, that peer educators were able 
to disseminate high quality information to their peers with ease, not only because they made 
higher grades on their knowledge test (see below), but also because of their extensive training,. 
The point is therefore that whilst the Peer Links competed with peer educators in terms of 
number output, the latter could be expected to be more effective in terms of quality of output. 
Interestingly, a number of Peer Links (five males) joined forces with peer educators and served 
in the absence of the peer educators’ cell members. One 16-year-old male Peer Link explained, 
“A dem get the better training but they still need us. Still this is good for me as I am learning 
some new things here about passing on information and taking control of an audience.” 
Construction of Peer Educator Cells 
Teams of peer educators were selected based on geographic factors such as closeness of and 
proximity to the same school. For proximity to work, particular institutions have to be in place: 
same church, same age, friendship, and family relationship. It was common to find many cell 
members who lived within a mile radius never met or even called since camp. Many cultural and 
economic barriers prevented these cells from working as planned. There were cases where cell 
members were unable to help each other because they were from opposing churches. The parents 
of one girl, for example, would not encourage their daughter to go to the Pocco Church down the 
road where another Cell Member desperately needed help. Size was also an issue. It did not 
matter how the groups were configured, it always came down to twos and threes. The larger 
groups became split into several smaller cells based on association from school, church, or due to 
family connections. Class was also an issue. Among females, some of the poorer cell members 
felt that though they attended the same school, they were traditionally from different sides of the 
fence and hence expected reluctance on the part of the middle class cell member. 
17 
In summary, what happened is that the groups reconfigured themselves along lines of friendship, 
family, economic situation and largely ignored the cell frame that was suggested at camp. The 
result is that much work was done as the peer educators ended with cells in which they felt 
comfortable. 
Factors that Impact on the Size of Networks Created 
A critical find is that the extent to which a youth established a network depended primarily on 
his or her personality. The second important factor was that of connections. Those who had 
access to youth clubs, churches, work sites, and football teams established larger networks. 
Factors such as confidence level, gender and age were also important. 
Personality and Confidence Level 
Friendly personalities were most advantageous, but when combined with confidence made for a 
powerful cocktail. Five categories of personality/confidence combinations were observed: 
• Natural leaders: very confident, very friendly, outspoken, and having the ability to 
mobilise or attract others towards them 
• Confident and friendly 
• Friendly, but a bit reserved 
• Reserved or shy: introverted, not outspoken, but most doing well academically; also 
seen as attractive by others due to being quiet 
• Antisocial: not friendly, and does not like conversation. 
In order to categorise the peer educators, team members were asked to make use of a series of 
items on the instrument (“describe yourself,” “self rating,” “academic performance”). From very 
early, it was found that those with better academic performance were significantly more 
confident. Team members spent more time with peer educators than other respondents. 
Additionally, they had to trace the peer educators’ networks as well as note qualitatively the 
educators’ personalities and connections. Table 4.1 and Figure 4.1 show that peer educators with 
natural leadership qualities or who were confident and friendly produced far more networks than 
those who were less confident or reserved. 
Table 4.1: Personality and Confidence Level by Number of Network Created 
Networks 
created 
Natural 
Leaders 
Confident 
Friendly 
Friendly but a 
bit Reserved 
Reserved Anti￾social 
1-5 0 1 0 4 1 
6-10 1 1 4 6 1 
11-20 0 4 3 0 0 
21-30 1 4 0 0 0 
31-40 1 0 0 0 0 
41-50 3 2 0 0 0 
51-100 4 1 0 0 0 
>100 5 0 0 0 0 
Total 15 13 7 10 2 
Mean Scores 79 26 11 6 5 
18 
Figure 4.1 
Mean Scores by Personality and Levels of Confidence 
0 
10 
20 
30 
40 
50 
60 
70 
80 
Mean Scores 
Mean Scores 
Natural Leaders Confident Friendly Friendly but a bit Reserved Anti-social 
Reserved 
Personality and Levels of Confidence 
Gender and Age 
If measured by sheer numbers, females created more networks than males. On average, a female 
produced 43 networks compared to a male’s 31 (see Table 4.2). 
Table 4.2: Network by Age and Gender 
Age Cohorts Males Females 
10-13 21 36 
14-16 12 40 
17-19 59 54 
Mean 31 43 
Undoubtedly, numbers are important in every investment. Qualitatively speaking, team members 
found the boy’s stories to be more touching. We found that only the boys could reach the boys. 
Whilst many girls spoke to boys “even when they come trying to look me” the boys were often 
too preoccupied with the wish to “get” the educator that they often forgot most of the 
information. In some cases, the boys stopped going to the girls after they realized that the 
educator would not yield. Boys who play football together or formed themselves into crews often 
decide as a group to FFLF (find them, fuck them, leave them, find more). When boys move in 
packs like this, reaching one of the “Toppa Dappa” like Bim (pseudonym) means you have 
reached the team. In Bim’s case he reported that his entire crew has been affected, “I think 
Youth.now may have saved not only my life, but theirs.” Careful examination of Figure 4.2 tells 
us that between 14 and 16 years of age, adolescents are most likely to face the most challenges. 
The data showed that this group was the least confident and made the lowest grades in school. 
For boys, the situation was worse. Notice that boys in the 14 to 16 age group produced 
19 
significantly fewer networks than boys 10 to 13. Notice, however, that even in the girl’s line 
there is a dip, though their networks grew progressively as they got older. Work in other projects, 
including Chevannes and Gayle (2000) and St. Catherine Adolescent Study, support this trend. 
Clearly, this age group needs a disproportionate investment over others. 
Figure 4.2: 
Network Created by Age and Gender 
Number of Networks 
70 
60 
50 
40 
30 
20 
10 
0 
Mal
l
es 
Fema es 
10 to 13 14 to 16 17 to 19 
Age Cohorts 
The Targets of Peer Educators 
Network Pool 
Peer educators created networks amongst persons they knew to some degree, beginning with 
their friends. The data is organized into a sequence ranking below in Table 4.3. It was surprising 
that less than half of the peer educators (22 of 47) targeted family members. Upon investigating, 
it was found that many youth felt more comfortable to discuss matters of reproductive health 
with friends than with family. Females were more likely to speak to their sisters. Peer educators 
also explained that they spent more time with their peers at school and in the community than 
with family members. There were, however, cases where boys and girls spoke to their fathers 
and mothers about what they were learning. Three females (17-19) said they focused on their 
partners. Ten youth assisted at clinics and other public forums, and six worked with youth clubs. 
Two of these youth clubs were started by peer educators acting alone. Twelve were allowed to 
work with the youth at their church. Ten of the peer educators are females; boys seemed less 
likely to attend and participate in church activities. 
20 
Table 4.3: Network Pool 
NETWORK 
POOL 
School Community Family Church Public Youth 
Club 
Work 
Number 36 25 22 12 10 6 2 
Ranking First Second Third Fourth Fifth Sixth Seventh 
Friends 
Most of the peer educators targeted friends who attended the same school (29 of 36). Most of the 
friends that were targeted came from the same community, though others came from 
communities within a 10-mile radius (see Table 4.4). This is important, as is helped to ensure a 
wide spread of information. Of interest is the fact that three girls sent material they learnt to 
friends abroad via the Internet. Table 4.5 shows that most friends targeted were the same (plus or 
minus a year) age as the peer educator. Females were more likely than males to target older 
males, up to 10 years or more. In three cases, these men were their sexual partners. Only males 
17-19 were likely to target friends two to five years younger. In all three cases, these friends 
were females who were attracted to the male peer educators. 
Table 4.4: Spread of Network Friends 
DISTANCE Same Near (<5 Miles) 5-10 Miles >10 miles 
NUMBER 38 26 24 3 
Table 4.5: Age of Friends Targeted 
AGE Same 2-5 Years 
Older 
6-10 Years 
Older 
>10 Years 
0lder 
2-5 Years 
Younger 
NUMBER 34 5 4 4 3 
Concerns 
1. Throughout the fieldwork, peer educators living outside the capital town expressed concern 
that there were times when they needed pamphlets and posters for presentations at clubs or 
other group sessions. They explained that they were aware they could go to see the parish 
coordinator at the clinic in Savanna-La-Mar, but they did not always have the fare to go see 
her. Instead they tried to innovate. One young lady even went early so she could draw the 
diagrams on a chalkboard to be used in the presentation. It might be prudent to provide these 
peer educators with more material so their tools do not run out when needed. 
2. For many peer educators the training changed their lives so drastically it is difficult to 
imagine. Many of the youth, especially males, became so suddenly responsible that even 
their teachers got caught in the rush. Peer educators were often given the opportunity to teach 
their peers in class. In two cases they were asked to assist the guidance counsellor. One 
mother expressed anxiety that her son might forget he had examinations and spend too much 
time helping his teacher prepare presentations in adolescent reproductive health. It might be 
wise to warn future peer educators about being overly involved at the expense of school 
work. 
3. Being a peer educator automatically gives youth respect most never thought possible. “I was 
called ‘sir’ for the first time in my life,” said one young man. The problem is that whilst 
21 
being a peer educator makes a youth an agent of Youth.now, most have little idea of what is 
happening and cannot give critical information to the very network people they reached. “My 
greatest embarrassment is when people ask when the next camp will be held and if me can 
put in a word for him. Imagine me tell you all these new and glorious things and all this 
respect; then me cannot tell this youth any serious thing about Youth.now plans. It is in fact 
appropriate for peer educators to play a role in making recommendations for recruitment. Not 
only do they deserve to be that involved administratively but they can provide youth who 
most urgently need to attend camp.” Some have expressed losing respect and support in their 
gatherings because they do not seem to know enough about the mother agency to be 
legitimate. They need to be a part of the information network of the agency. Probably the 
creation of a small newspaper might be helpful to keep peer educators and facilitators 
informed. One peer educator suggested that a web link could be created. Persons could go to 
the library where they could communicate with each other. 
4. Though peer cells are most active as small units of two and three, it might still be good for 
those in a given locale to come together for monthly meetings. This might serve to strengthen 
some peer educators on both a personal and work basis. They could have focus group 
discussions regarding practices, challenges, opportunities, and impact on their personal lives. 
5. The final concern surrounds the issue of the personal development and lives of the peer 
educators. Of all the peer educators who had networks, over 50 had a story of struggle. In 
fact there were cases in which team members questioned the level of their commitment to 
Youth.now’s programme given the harsh economic conditions they faced daily. What was 
discovered was that Youth.now gave them so much hope that they “…just want to go 
forward in life, not just with this peer educator thing, but with my life.” The dilemma is that 
Youth.now takes a girl or boy whose life was in shambles, gives them self esteem and a 
reason to live, and then they are on their own and the reality of failure and frustration returns. 
This would be counter to the aims of the project. 
Take Bobby (pseudonym), for example. He took a long knife to camp, almost attacked a 
camp counsellor for simply pointing out to him that it was unnecessary to be arrogant. He 
called the programme “nonsense!” and resisted until he returned home. He felt it had to be an 
error why he was called to return to become a peer educator; nonetheless, he went. He 
claimed he had nothing doing. Now he is respected at school, as he assists the guidance 
counsellor. He is a mentor to other peers. Now he wants to be chef, but who is going to help 
him. And if he fails, what would that mean for Youth.now? 
There is also Sean (pseudonym) who has been acting as guidance counsellor at his school. 
Nonetheless, he could only find money to do one CXC, though quite bright. He still does not 
know how to get the money to do others. He is also on his own. And there is the example of 
Beyonce who formed a club but needs to return to school. Like Sean, she needs urgent help. 
Youth.now’s mandate is not to act as a welfare service. Nonetheless, it might be forced to 
take on the role (or expand, if it has not already has begun to do so) to lobby with 
government and non-government agencies to find help for these youth. 
22 
CHAPTER FIVE 
The Impact of the Intervention 
In order to understand and measure the impact of the Peer Links and educator camps, it is 
necessary to lay out a background of the sexual practices and history of the respondents. Some 
intervening variables cannot be ignored in this evaluation. As such, socio-economic background, 
gender, age, and others are detailed before the assessment of the impact. 
Sexual Debut 
The modal age where sex began is 14. Table 5.1 and Figure 5.1 show clearly that socio￾economic background is critical. Supported by many previous studies (including Chevannes and 
Gayle 2000) only suburban and semi-urban lower middle consistently delayed sexual intercourse 
until age 14. The adolescents of the urban lower middle due to proximity to the urban centre 
were more likely to mirror the early sexual debut associated with the urban poor. 
Table 5.1: Sexual Debut by Socio-economic Background 
5 - 8 9 - 10 11 - 12 13 - 14 15 - 16 17 - 19 
Suburban (13) 0 0 0 1 0 1 
Urban Lower Middle (26) 3 2 1 3 5 2 
Semi-urban Lower Middle (15) 1 0 0 2 4 0 
Urban Working Class (26) 3 1 5 2 2 2 
Inner City (42) 4 4 4 2 7 0 
Semi-urban Working Class (66) 2 3 4 12 13 1 
Rural Poor (10) 1 1 1 1 0 1 
Figure 5.1 
Sex Debut by Socio-economic Background 
14 
12 
10 
8 
6 
4 
2 
0 
5 to 8 9 to 10 11 to 12 13 to14 15 to 16 17 to 19 
Sex Debut 
Number of Persons
iddle 
i le 
i l
i
i i l
l
Suburban 
Urban Lower M
Sem -urban Lower Midd
Urban Work ng C ass 
Inner C ty 
Sem -urban Work ng C ass 
Rura Poor 
23 
Gender is an extremely critical factor in the matter of sexual debut. As can be seen in Table 5.2 
and Figure 5.2, it is very unlikely that males will begin having sexual intercourse as late as 16, 
the age of consent, which is the age many parents begin to speak to their children about sex. 
Clearly males begin to have sex during the pre-puberty years. The data suggest that the males in 
Westmoreland are more likely to begin having sex between the ages of five and 13. What is 
alarming is that 41 percent (24 of 58) of the boys who had had sex had their sexual debut in the 
pre-puberty years. For females this is quite the opposite. They seem to begin having sexual 
intercourse at about age 14. By age 16, it is most likely they would have sexual intercourse at 
least once. Only four females had sex earlier than age 13. Two of these girls were raped. 
Table 5.2: Sexual Debut by Gender 
5 - 8 9 - 10 11 - 12 13 - 14 15 - 16 17 - 19 
Male 13 11 12 13 6 3 
Female 1 3 10 25 4 
Figure 5.2 
Sexual Debut by Gender 
30 
25 
20 
15 
10 
5 
0 
Male 
le 
5 to 8 9 to 10 11 to 12 13 to14 15 to 16 17 to 19 
SEXUAL DEBUT 
Number of Persons 
Fema
Whether or not condoms are used at sexual debut depends primarily on age (and to a lesser 
extent gender), not socio-economic background. Females mature earlier and are usually more 
informed in their early teens. Notice that no one who had first sexual intercourse before the age 
of 11 used a condom. Notice also that only after age 13 did it becomes likely for an adolescent to 
use a condom—and most likely after age 15. The “no” line in Figure 5.3 clearly shows the trend 
is that the longer a person delays first sex, the more likely it is that he or she will use a condom. 
In fact, it is believed that a significant number of Jamaican youth contract HIV the very first time 
24 
they have sexual intercourse—including those who had sex during the pre-puberty years when 
condom use is not fully appreciated. Delaying first sex is therefore extremely important in the 
struggle to prevent the spread of HIV. 
Table 5.3: Use of Condom by Age at Sexual Debut 
Use of SEXUAL DEBUT 
Condom 5 - 8 9 - 10 11 - 12 13 - 14 15 - 16 17 - 19 
Yes 5 15 27 6 
No 14 10 11 7 5 1 
Figure 5.3 
Condom Use by Age at Sexual Debut 
30 
25 
20 
15 
10 
5 
0 
No 
5 to 8 9 to 10 11 to 12 13 to14 15 to 16 17 to 19 
SEXUAL DEBUT 
Number of Persons 
Yes 
The Recruits 
Treating the quantitative data collected on sexual debut as an important indicator of the 
respondent’s sexual practice and history, the researcher compared the sexual debut of recruits 
with the other respondents to assess the claim made by trainees, their parents, community 
leaders, and facilitators that some of the youth who were invited to the Peer Links camps were in 
fact in trouble. Table 5.4 displays the data and shows that recruits to the Peer Links camps had 
significantly earlier sexual debut than other respondents. Over 44 percent of the total had first 
sexual intercourse before age 13, when it is likely that a condom will be used. The data seem 
therefore to support the recruits’ testimonial (especially males) that they needed help and found 
salvation in the Youth.now programme. The narratives written on the instruments provide us 
with some details of boys who were involved in batteries (5), gang war (7), and even petty theft 
25 
with very little concern about the direction life was going. The important point here is that those 
recruited to the programme were no better than the networks created or the control. 
Table 5.4: Sexual Debut: Recruits Compared to Other Respondents 
Age at Sexual 
Debut 
All Recruits: Peer 
Educators and 
Links 
Network and 
Control 
5 - 8 11 3 
9 - 10 5 7 
11 - 12 7 7 
Sub (%) 44% 35% 
13 - 14 10 12 
15 - 16 16 16 
17 - 18 3 4 
Total 52 49 
Impact on Sexual Behaviour 
This section focuses on the extent to which the programme helped youth to delay having sexual 
intercourse, increase condom use, and reduce the number of sexual partners. In the introduction 
it was highlighted that the emphasis of the evaluation is not on behaviour change, but rather on 
attitude and knowledge, given the very short period of one year at most. 
Delaying Sexual Intercourse 
The data displayed in Table 5.5 is quite explicit. They show that the most profound impact in 
terms of delaying sexual intercourse was on peer educators. Half of the 26 peer educators who 
have had sex have not had sex in the past year. Eight of the 13 stopped having sexual intercourse 
directly because of the impact of camp. Three others had stopped having sex before going to 
camp, and two had not had sex since their sexual debut. This impact is undeniable. The impact 
on Peer Links was also noticeable. A third of those who had had sex did not do so in the past 
year and half of those were directly because of the programme. Significantly fewer networks and 
controls delayed having sex (9 and 19 percent, respectively). Assessing the conversations held 
with peer educators, they were more affected because they spent more time at the camps and also 
because of the added sense of self and responsibility: “It’s as if you cannot do something you 
telling people not to do” (14-year-old female). For peer educators, delaying sexual intercourse 
goes beyond the reason of contracting a sexually transmitted infection or the scare of pregnancy. 
Table 5.5: Respondents who have not had sex within the past year by groups 
SITUATIONS PEER EDS PEER LINKS NETWORK CONTROL 
No sex since camp 8 4 0 0 
Stopped having sex 3 4 2 3 
Had no sex since debut 2 0 0 2 
Total 13 8 2 5 
As % of N 50% 31% 9% 19% 
N 26 26 23 26 
Condom Use 
The data on condom use also distinguish the youth who received training from the networks and 
controls. Again, the peer educators present the most mature behaviour, with almost all using a 
condom every time. Only two male peer educators expressed that they used condoms only 
sometimes. Both had a steady partner with whom no condom was used, but also second 
26 
relationships in which condoms were used every time. Three-quarters of all sexually active Peer 
Links used condoms every time. Of the remaining few, one does not use condoms with his 
steady partner, but he does with any of his other two partners; one reserves the practice of non￾use of condoms for virgins (a very unsafe practice); and two others gave no reason for not using 
condoms every time. Not only did a smaller proportion of the sexually active network and 
control use condoms every time, but they also gave no rationale for irregular use. One 13-year￾old network stated that he uses condoms only if “feel to use it.” It is important to note the impact 
of peer educators on networks: three networks reported that their sexual behaviour was changed 
in terms of condom use due to their contact with peer educators. 
Table 5.6: Condom Use by Groups 
SITUATIONS PEER EDS PEER LINKS NETWORK CONTROL 
Use condom every time 11 14 13 11 
Every time since camp 4 4 
Every time 7 10 10 11 
Every time since peer 
educator 
3 
As % of N 85% 78% 62% 52% 
Use condom sometimes 2 4 6 9 
Not with steady partner 2 1 
Not with virgins 1 1 
If partner wants 1 
No reason 2 4 9 
No condom use 0 0 2 1 
N 13 18 21 21 
Number of Sexual Partners 
The difference in number of sexual partners between peer educators, Peer Links, and networks 
was not significant. It is important to highlight that a number of networks were affected by the 
input of peer educators. In fact, those who decided to use condoms every time after being tutored 
by peer educators also decided to reduce their number of sexual partners. It follows, therefore, 
why only the controls were different, as seen in Table 5.7. A number of young men who had 
gone to camp “to look a different gal” came home and started to tell their friends to have less 
girls and use a condom every time. Nonetheless, reducing the number of sexual partners is 
difficult and requires a longer period to be properly observed. The problem is that number of 
partners remains an indicator of masculine identity in Jamaica. Persons who decide today that 
he/she will have one partner might revert to a multi-partner situation without further intervention 
of some kind. 
Table 5.7: Number of Sexual Partners by Groups 
NUMBER PEER EDS PEER LINKS NETWORK CONTROL 
1 9 13 14 8 
As % of N 70% 72% 67% 38 
2 0 1 3 3 
3 3 1 2 5 
4 1 2 0 1 
5 0 0 0 1 
More 0 1 2 3 
N 13 18 21 21 
27 
Impact on Attitude 
Behaviour change is largely dependent on attitude change. The latter, however, is largely 
dependent on knowledge and is an important means of measuring the quality of information 
transferred to youth. It is very easy to transfer an imbalanced account of adolescent sexuality. In 
fact, one of the weaknesses of the quality of information youth received from parents is that it is 
often so mixed with anxiety that it lacks balance and, hence, appeal to reality. Table 5.8 
highlights the data on the quality of information the trainees received and the kind of attitude the 
Youth.now team tried to instil in the youth. 
Table 5.8: Quality of Discussion of Sex during Adolescence by Groups 
QUALITY OF 
DISCUSSION 
PEER 
EDUCATORS 
PEER LINKS NETWORKS CONTROLS 
Balanced 
Discussion 
31 25 24 13 
Against, but very 
well defended 
15 22 14 13 
Imbalanced: one 
fair, other poor 
1 0 1 6 
Poor: for or against 0 5 8 20 
Total 47 52 47 52 
The youth trained by Youth.now and affected by its trainees were better able to discuss matters 
related to sex during adolescence. They were more likely to present a balanced view of sex 
during adolescence, and where they could not find any positives about early sexual activities, 
presented strong arguments why sex should be delayed. It was rather alarming to find that half 
(26) of the controls were unable to present a balanced discussion or defend a position taken. 
There was a large gap between networks and controls; it was so obvious there had to be a search 
for intervening variables. There was no dramatic impact by gender (overall girls were more 
eloquent); age (10-13 presented the poorest discussion across all groups); or socio-economic 
background (not a factor). The logical conclusion seems to be that peer educators are so effective 
that they are a better source of data on matters of adolescent reproductive health than parents and 
other service providers to youth. It also suggests that something might be wrong with the way 
adolescents are taught material about sexuality—particularly in the area of balance. It is 
impossible to ignore the fact that networks were able to produce a comparable proportion of 
balanced discussion overall with Peer Links. Figure 5.4 makes this obvious. 
28 
Figure 5.4 
Quality fo Discussion of Teen Sex by Groups 
35 
30 
25 
20 
Number of Person 
15 
10 
5 
0 
PEER EDUCATORS 
PEER LINKS 
NETWORKS 
CONTROLS 
Balanced Against but Imbalanced: Poor: For or 
very well One fair, Other Against 
Defended poor 
Quality of Discussion 
Arguments For and Against Having Sex During Teenage Years 
Below are some of the more popular responses for and against having sex during teenage years. 
They are divided into convincing and unconvincing responses to allow the reader to understand 
how the responses were assessed, given the degree of subjectivity involved. 
The 10 to 13 Age Group 
During the piloting of the instrument, it was found that the 10 to 13 age group struggled with 
some of the attitude areas, including the discussion of teenage sex. As a result, an additional 
table was included to discuss simple day to day issues of reproductive health. The focus of this 
section was to better afford the team a chance to assess the attitude and knowledge of the early 
teens. Respondents were asked to say what the following meant to them: being a boy/girl, having 
a child, having a boy/girlfriend, having sex, right age to have sex, being a teenager, and 
becoming an adult. It was felt that the issues were so simple that the older groups would not 
necessarily need more than school family life education to respond to them. In the age categories 
14 to 16 and 17 to 19, those who went to camp were marginally better equipped to respond to the 
simple questions than those who did not (with peer educators more advanced than every other 
group). 
Controls 10 -13 were very disappointing: Sixty percent (12) said they “did not know” to most 
questions, spoke of something irrelevant, or gave a response that was not useful, such as: 
“I like being a boy.” 
“I don’t like girls.” 
“Girls are nice, I like the sexy ones.” 
“Having sex and girls is yuck!” 
29 
Convincing Responses For 
• Hype, attention (have girls screaming your name at • 
school) • 
• Fun or pleasure • 
• Having a son early can give direction to a youth here • 
(inner city) • 
• Sex is often a necessity to keep mate • 
• Peer pressure, wanting to belong 
• Substitute for love • 
• Experimentation: making sure that everything 
functions right • 
• To feel like an adult • 
• Love or infatuation can lead you places 
• Money or financial support 
• 
• 
Unconvincing Responses For 
• Girls fi get wood • 
• Sex must not go to waste • 
• Some girls won’t look good after they past 16 • 
• It is envy why some adults want us to wait • 
• We all have to die • 
• If they don’t get sex they will kill themselves from 
stress, need to release 
Convincing Responses Against 
STIs 
Pregnancy 
Lack of focus, as well as being kicked out of school 
Affect self esteem negatively 
Problems with family 
Blight future, as would not be able to afford caring 
for a child 
Sex costs money which could be used towards 
education 
Emotional problems 
Bad reputation/branded a sketel that can lead to 
being treated as a ghetto bicycle and includes rape 
and batteries 
Attacked physically, as teenagers often have 
relationships with persons who already have 
relationship for the purpose of getting support 
Health issues: cervical cancer 
Unconvincing Responses Against 
Won’t have any stamina left if you start early 
Bible says not to 
Will get crab louse and become useless 
Will die 
Will grow up sicky-sicky 
Most of the boys reacted more positively to the questions of sex. Some girls became overly shy 
when the issues were raised. Some girls became so withdrawn in response to these day to day 
questions that this table became a key indicator to interviewers as to how deep they could go into 
the instrument with early teens. Quite interesting is the fact that a number of the boys expressed 
that they were anxious to have a girlfriend and begin having sex. “I want four [children] when I 
grow up,” said one sharp 10-year-old. 
Networks 10-13 were much better with 81 percent (13 of 16) good responses. They also showed 
signs that they had discussed the issues with their peer educator friends. They were more relaxed 
and demonstrated a better attitude towards sex and the future. There was no identifiable 
difference between networks and Peer Links in terms of responses or attitude. In fact, slightly 
less Peer Links (75%) gave comparably good responses. Among the peer educators were three 
gifted children (lower middle class boys) who have recently passed their placement examinations 
for Mannings High School. Their responses were quite advanced, comparable with that of the 
older groups. Some interesting responses: 
Difference between boys and girls: 
ƒ Boy ramp, girls stay inside 
ƒ Boys love fight, girls tek man 
ƒ Boys do outside work, girls wash clothes 
ƒ I can sex girls and leave them like my friends 
ƒ Girls have too much to do, boys idle 
ƒ Boys are more fun, wish I was one 
30 
Having a child: 
ƒ Sounds painful to me
ƒ Not really for children 
ƒ Would like to be a father when I have the means 
ƒ Absolutely great but must be well timed 
ƒ Having a child early could be a hand luggage, baby not wearing now 
Having a girl/boyfriend and sex: 
ƒ Nice, can’t wait 
ƒ Yes, so I can have a fulfilled life and not be lonely; but that’s for later, not now 
ƒ Oh yes, kissing is nice, a bit wet though 
ƒ Could get pregnant but that is what condoms are for, to stop these things. 
ƒ Really requires some amount of maturity – not for children. I am only 11. 
ƒ Why not, but I will wait until I understand it well 
ƒ Should not have sex if you cannot fit a condom well. My friend said this to me that he 
learnt at camp. 
ƒ This girl in the class she has sex for coco-bread; I rather God keep me as a nun than do 
something like that. 
Adult life and teenage life: 
ƒ Adults have plenty stress, teenage life have free time
ƒ Can go to dance on my own when I am big 
ƒ Can’t wait so I can play cricket and be independent 
ƒ Can’t wait to leave my mother’s house 
ƒ Teenage means you are growing up, just be patient 
Attitude Towards Delaying Sex 
Overall trainees were more likely than networks and controls to see delaying sex until after 
completing secondary school as an ideal. Attitude towards delaying sex is a gendered issue. Girls 
consistently strive for the ideal of delaying sex towards the end of adolescence. Table 5.9 and 
Figure 5.5 show that females’ attitudes were only slightly affected by the intervention, as there is 
now a significant difference in the desires of females across groups. The profound impact of the 
intervention in this regard was felt by males. Males’ attitudes changed dramatically after going to 
camp. Figure 5.6 isolates the data on the males, showing clearly that boys who attended camp 
were more likely to consider delaying sex as an ideal. It distinctly shows a decline in 
appreciation for delaying sex as one moves from peer educators to Peer Links to networks to 
controls. Concurrently, the attitude that delaying sex is but an unwanted ideal increases along the 
same line. 
Table 5.9: Attitude towards Delaying Sex by Gender and Groups 
Degree of 
Importance 
Peer Educators Peer Links Networks Controls 
M F M F M F M F 
VI 18 22 16 23 11 19 11 23 
IMP 4 2 8 4 6 4 9 3 
NOT 1 0 1 0 6 1 5 1 
Total 23 24 25 27 23 24 25 27 
31 
Figure 5.5 
Attitude towards Delaying Sex by Gender and Groups 
0 
5 
10 
15 
20 
25 
M F M F M F M F 
i
VI 
Number of Persons 
Peer Educators Peer L nks Networks Controls 
Gender and Groups 
IMP 
NOT 
Figure 5.6 
Male Attitude towards Delaying Sex by Groups 
0 
2 
4 
6 
8 
10 
12 
14 
16 
18 
M M M M 
i
VI 
Number of Persons 
Peer Educators Peer L nks Networks Controls 
IMP 
NOT 
Groups 
32 
There was a clear gap between the attitude held by boys before going to camp and the attitudes 
displayed after completing the course. Before the camp, both peer educators and Peer Links felt a 
mean age of 16 was right for initiating sexual activities. The age they presented as ideal after 
returning from training was a mean of over 19. Modal scores were 18 and 21. The modal and 
arithmetic averages of controls and networks reflected the perception of peer educators and Peer 
Links before they were trained. The age of 16 seemed to be important to the boys, because it is 
the age of consent in Jamaica. There were some variations worth noting. Before going to camp, 
seven male peer educators and six Peer Links held the view that 18 to 21 is the correct age to 
begin having sexual intercourse. There was also one rural male who was convinced even after 
training that age did not matter. 
Attitude Towards Multi-partner Relationships 
Two times more male control and network respondents were supportive of multiple partners than 
trainees (29 compared to 15). Five females supported multiple partner relationships on the 
grounds of needs. One female peer educator who has two relationships explained, “There are 
times when the nice things you learn have to be used to guide you through the rough waves of 
life. You just cannot do everything you learn because you cannot afford that luxury.” One of the 
realities that Youth.now has to work with is that of the constraints of poverty. 
Sexual Performance as Important to Masculine Identity 
Significantly more networks and controls (36 compared to 27 trainees) paid attention to sexual 
performance as a means of masculine identity. Youth who went to camp expressed that they felt 
the same way before camp, but having gone and received the training they rely on many other 
sources to “…boost my self esteem, without telling people that I have a big penis or such.” The 
issue of age was, however, critical: 14 to 16 year-old males were more likely than any other 
group to consider penis size and sexual performance an issue. Interestingly, the females of that 
group were also more like to support the males’ view, expressing that it is important that a male 
be a “wuckaman.” 
Table 5.10: Sexual Performance as Important by Age and Groups 
Degree of 
Importance 
Peer Educator Peer Links Networks Controls 
10-13 14-16 17-19 10-13 14-16 17-19 10-13 14-16 17-19 10-13 14-16 17-19 
VI 3 3 4 1 6 2 2 5 1 3 2 2 
IMP 1 3 2 0 2 0 3 3 4 1 8 2 
VI & IMP 4 6 6 1 8 2 5 8 5 4 10 4 
NOT 4 2 1 9 2 3 3 2 0 6 0 1 
Total 8 8 7 10 10 5 8 10 5 10 10 5 
Impact on Knowledge Base 
A test to measure knowledge of basic adolescent reproductive health was piloted with two 
adolescents of each age cohort. The difficulty level was not relaxed, so it could be used as a 
useful measurement of a programme that claimed it gave adolescents an intensive training in 
adolescent reproductive health. The test was marked out of 100. A glimpse at the cumulative 
scores for knowledge on issues of reproductive health clearly shows the efficacy of the 
intervention in Westmoreland: 
33 
ƒ Peer Educators: 3,187 
ƒ Peer Links: 2,771 
ƒ Network: 2,622 
ƒ Control: 2,179 
Table 5.11: Mean Scores of Knowledge Test by Age, Sex, and Groups 
GROUPS MEAN 10 to 13 14 to 16 17 to 19 
Male Female Male Female Male Female 
Peer Educators 69 56 65 60 74 67 89 
Peer Links 55 44 54 49 58 57 64 
Networks 57 44 42 58 62 64 70 
Controls 43 28 36 42 52 45 55 
MEAN 56 43 49 52 62 58 70 
Table 5.11 shows the mean scores according to age, sex, and groups. The data showed that sex 
and age were important intervening variables. Females consistently out-performed males at all 
levels on the test. The older the adolescent, the higher the scores tended to be. These 
observations are displayed in Figure 5.7. There were nonetheless some important exceptions to 
this trend. For instance, controls that attend the Mannings High School received higher scores 
than those who attended other schools, a reflection of the quality adolescent reproductive health 
programme operating at this school. Students who had high academic grades also tended to do 
better, but even the academically inclined had difficulties with certain areas. It is fair to say, then, 
that controls who got grades above 70 percent had received some training in adolescent 
reproductive health. Very few such cases occurred, including the son of a science teacher and 
daughter of a health provider. All the persons who received grades above 80 percent can be 
described as outstanding and well-informed in the matter of adolescent reproductive health. 
Figure 5.7 
34 
Knowledge Test Scores by Age and Sex 
0 
10 
20 
30 
40 
50 
60 
70 
80 
Male Female Male Female Male Female 
10 to 13 14 to 16 17 to 19 
Scores
Female 
Male 
Age and Sex 
Overall, the youth who were trained by Youth.now and who were networked by the Youth.now 
trainees were very noticeably more informed about reproductive health issues than the controls. 
Figure 5.8 displays a quantitatively isolated control group. Interestingly, there were only 
marginal differences between Peer Links and networks. In fact, the average scores of the 
networks tended to be slightly better. It is a reflection of the degree of work that has been done 
by the peer educators. It was encouraging to hear peer educators interrogating their recruits after 
they were interviewed. They always wanted to be sure that their network represented them well. 
Figure 5.8 
35 
Knowledge Mean Scores by Groups 
0 
10 
20 
30 
40 
50 
60 
70 
Mean Scores 
MEAN 
Peer Educators Peer Links Networks Controls 
Groups 
There is no surprise that peer educators got the highest scores, given that they received the most 
extensive training and were actively teaching the information to others. The difference between 
the scores of peer educators and the controls, shown in Figure 5.9 and 5.10, is greatest amongst 
the younger respondents and oldest. The gap then closes in the middle at the point of the 14-16 
year cohort of Peer Educators. This is not surprising; the 14 to 16 age group of peer educators 
and Peer Links were more preoccupied with self throughout the study than the other groups, and 
they networked the fewest persons (see Table 4.2 and Figure 4.2). The more involved a peer 
educator, the better he/she would be expected to perform on the knowledge test. 
36 
Figure 5.9 
Knowledge Gap between Peer Educators and Controls by Age: Males 
80 
70 
60 
50 
Male 
10 to 13 
Male 
14 to 16 
Male 
17 to 19 
Mean Scores 
ls 
Peer Educators 
Contro
40 
30 
20 
10 
0 
Age Cohorts 
Figure 5.10 
Knowledge Gap between Peer Educators and Controls by Age: Females 
100 
90 
80 
70 
Female 
10 to 13 
Female 
14 to 16 
Female 
17 to 19 
60 
50 
40 
30 
20 
10 
0 
Mean Scores 
ls 
Peer Educators 
Contro
Age Cohorts 
37 
Summary of Qualitative Data on the Impact of Camp on Peer Educators and Links 
Gender 
Clearly female peer educators, and to a lesser extent Peer Links, produced more networks. They 
also scored higher on the knowledge test. Nonetheless, the intervention’s greatest impact was felt 
by the boys who claimed they were in trouble and were rescued by Youth.now. Seven of these 
boys were members of two youth gangs that operated as parts of larger gangs. They all went to 
camp armed—two had guns, others had knives. Upon their return from camp, five decided to 
leave the gang. One relocated to Kingston, and another claims he is “…chilling out, 
contemplating things, anything can happen.” The following are other stories of how boys have 
changed their lives as a result of the camps: 
ƒ Danny went to camp to find a girl but returned as a Peer Link to find his life changed. 
He now takes responsibility to tell his friends to make sure they use their rubbers. 
ƒ Carl stopped having sex with his “crowd of girls.” Upon his return, he started dating 
one steady girl and focussed on his school work. In his present relationship, sex is 
delayed “…until we are old enough.” 
ƒ Dawg, who had eight girlfriends with whom he had sex on “shifts,” returned home and 
selected one girl that he describes as his “queen.” Recently, one of the other girls 
returned to “stress me and me allow her to feel me up and halfway through it, I 
remembered my commitment to myself and just stopped.” 
ƒ Little Blue came to realize that sex is best enjoyed after teenage year and intends to 
delay. Given his strong family support, he might achieve this. 
ƒ Rushman, a peer educator, commented, “I said to myself, Jesus, I am 13 and have five 
girls and having sex weekly like an adult. I stopped. I came home and taught my whole 
crew how to hype without sex. Let the girls them rush but not tough. I am still a child. I 
might be handsome and popular, but still a child. I will not let anyone or anything steal 
my childhood, especially AIDS.” 
Age 
Undoubtedly the greatest impact was on the 10 to 13 year-old age group. Qualitative data put 
them ahead of the other groups, although they could not be fully assessed quantitatively due to 
their age or lack of a history (on the part of most). Quantitatively, it could be seen that the widest 
gap in knowledge was between 10 to 13 year-old peer educator males and their control 
counterparts. The attitude of the 10 to 13 year-olds was extremely promising. All five boys 
highlighted above surprisingly belong to the 10 to 13 year-old age group. I selected these from 
the many stories of drastic change, because these boys were undoubtedly rescued. They are from 
the inner city and urban working class. One of them can barely read but has resolved to do better 
in school and make something of his life. 
Socio-economic Background 
From the data collected, it became clear that the greatest impact was on those of the inner city 
and working class—the urban poor—and the least on those of suburban background. Only seven 
persons (5 suburban, 1 lower-middle, 1 inner city) said that the intervention had little or no 
impact on them. This is commendable. Five suburban youth said they were already informed 
38 
before going to camp, including one whose father works with the Ministry of Health. The one 
lower-middle class youth explained that her mom works with adolescents, so she has always 
been involved. The inner city youth went to camp to find girls, but found none. “Me never use to 
sex without boots and me still use my boots. Me not having less girls so me no see the impact. 
Me enjoy it still.” After assessing the impact qualitatively it became clear that it would make 
more sense to invest in less suburban youth and more of the inner city, semi-urban, and rural 
poor. 
Most Dramatic Impact 
One of the presenters at camp was seen by a number of male youth as very sexy. When she said 
she was HIV positive, it sent shivers down the spine of a number of the youth. Seven of those 
interviewed, ranging from age 14 to 17 (six males included) returned home and got themselves 
and partners tested. 
Self Esteem 
It was surprising when the trainees listed the programme’s focus on building self-esteem as more 
important than all the work in reproductive health. An inner city female peer educator explained 
why self-esteem is so important: “If they had just tried to tell us things, even if they new and 
exciting or even scary things, it would not have the same effect as them teaching us self-worth. If 
you respect yourself you almost win already.” The tally below shows that most of her peers 
agreed with her. 
Aspect of Adolescents’ Life Affected by the Intervention Ranked in order of Most Important to 
Least: 
1. Self esteem and life focus (63) 
Of the 63 trainees who listed self esteem as the primary value of the intervention, 33 reported 
they had a range of problems related to low self concept before they went to camp. The 
narratives below tell the self-values they sorted out: 
ƒ Taught me the good in myself and how to avoid the pitfalls. 
ƒ Taught me how to measure my small achievements and develop self pride. 
ƒ They brought out my leadership skills. 
ƒ I feel better about myself. 
ƒ I use to just focus on shooting some guys from the gang up the road. I am not a 
gangster now, I am a person. I came home and told them they are my friends. I even 
sold my gun. 
ƒ I never saw the worth of life; now I see a way out without violence. 
ƒ Learn to control myself; as a peer educator I am an example to others. 
ƒ Usually I would just knock you the first time you bother me, as a Peer Ed. I just 
laugh at you. I am in control and I have a greater self esteem now. 
ƒ Boost my self confidence - 100 percent boost. 
2. Provide information on reproductive health and foster a change in attitude towards sex (41) 
ƒ Learnt that delaying sex until after school is a wise decision. 
ƒ Use to think about sex daily till headache; now I know it is natural so I ignore it. 
ƒ No more unprotected sex for me. 
39 
ƒ I went and got tested, and it’s a new leaf for me. 
ƒ I did not even know about condoms, but I was having sex; things have changed. 
ƒ I know too much now to go back to where I was a year ago. 
3. Attitude towards others 
ƒ Use to be hostile to others, now calm and considerate. 
ƒ I have learnt to communicate, no need to rush or shout to be heard. 
ƒ I now think about others. I avoid using harmful words, consider the feelings of 
others. 
ƒ I feel I have to teach others what I have learnt. 
ƒ What to expect from the other sex. I am less hostile to boys now, always saw them 
as an invading force. 
4. Life Skills 
ƒ Helped me to listen, so now I learn easier. 
ƒ My grades have improved for I have learnt to organise my thoughts. 
ƒ How to socialize without falling to the tricks of sex player. 
ƒ I learnt how to check out a girl without harassing her. 
ƒ Leadership.
ƒ How to get people to listen even if they do not think what you are saying is 
important at first. 
Improvements Needed to Youth.now’s Programme
ƒ Nothing (31) 
ƒ Longer camp period and a single camp for all (24) 
ƒ No Peer Eds separate from Peer Links: just teach all of us the same (6) 
ƒ More drama, talent thing, football, and such activities (4) 
ƒ Less food, I went home heavy (4) 
ƒ Bad, they don’t take me back! (2) 
ƒ Camp take too few people: do you know how many children are still ignorant? (2) 
ƒ Needs to be longer so more interaction is allowed (1) 
ƒ Need to try and get sponsorship from private sector people to expand camp (1) 
40 
CHAPTER 6 
Some Pointers 
Only those who carried out a project can fully understand how some things were done and for 
what reasons. I suggest that the following are pointers and should be treated as such. I am 
providing here an alternative thought process, driven purely by evidence and some research 
intuition, to those who were involved in the intervention. They may reflect the thoughts of those 
who were involved, but they may differ widely and even challenge processes that have been 
known to work. In any case, I present them simply as suggestions for your consideration. 
Throughout the report I have presented my thoughts and those of the research team. At this point, 
I will highlight only the critical points and where necessary, illuminate them. 
Successful New Strategy 
The adolescent reproductive health intervention in Westmoreland was an enormous success. The 
only obvious threat is the fact that the programme can burn itself out if not carefully executed. In 
many ways, Westmoreland is a forgotten parish. The intervention was urgently needed and was 
obviously well appreciated, but without careful development planning, momentum can be lost 
and energy can recede. I describe the strategy employed by the project as new in that it is not 
traditional in a number of ways. The strategy seemed to focus on building self-esteem, providing 
information in a neutral manner that allows youth to make up their own minds, and facilitating 
adolescents sharing the responsibility of ensuring the future of their peers. The peer education 
strategy works, and, if properly managed, should remain as the primary approach to address 
adolescent reproductive health. 
Need for Permanent Partnerships 
The intervention awakened the hopes and dreams of a large number of youth, with immediate 
and direct impact on their families, peers, and communities. Those who intervene then run the 
risk of being regarded as ‘saviour’. This can be seen as a threat to projects that have limited 
budgets. Sanvanna-La-Mar and the larger area have enormous human resources and the capacity 
to mobilise itself very quickly. These opportunities, including the many networks available 
through the health service, social services, clubs, churches, and schools should be fully exploited. 
Nonetheless, this must be done within a frame of partnership. Most successful projects carry with 
them a flip side: leaders who should have seen the urgent need and should have done something 
about it a decade ago become agitated; people begin to adopt the strategy of the new successful 
team and forget that their old system worked for generations, and, in fact, facilitated the success 
of the new methods used. Worst of all, community leaders and youth develop a sense of 
dependence on the new deliverer. It is always important to ensure that a project can be sustained. 
Youth.now might not be able to continuously host camps, but it can teach local churches, service 
clubs, and schools how to run effective adolescent camps with dramatic results. If Youth.now 
could reconnect the many under-utilised centres and groups in the parish, it can soon take on a 
supervisory role and facilitate the independent growth of the adolescent reproductive health of 
the parish. 
41 
Method of Recruitment and Selection 
The evidence seems to suggest there was heavy reliance on traditional networks within the 
parish. The means of recruitment was also many-pronged. Using the networks already in place, I 
suggest the parish be stratified by geo-social settings in an attempt to represent each major and 
critical smaller area in the sample. Recruitment was purposeful and targeted needs as identified 
in the needs assessment. However, not all the vulnerable adolescents could be located for 
inclusion in the intervention. Similarly, a better job could have been done to enable that those 
selected for further training, as peer educators, reflect the most vulnerable. 
Striking a Balance 
The data show that females and older adolescents created more networks. The evidence also 
showed that friendly extroverted personalities and high levels of confidence (a combination that 
is more readily found among the non-poor) were critical factors in the creation of networks. On 
the other hand, the most vulnerable are better able to reach the most vulnerable. If young boys 
were the most affected and were the ones most urgently needing the intervention, then there is a 
problem, given that those who can best reach the most desperate do not make for good peer 
educators. There seems to be at least two ways out of the problem. The first is to train a cadre of 
leaders selected from every group proportionately to needs but ensuring every group is well 
represented. The second is to extend the Peer Links training to include the critical leadership 
lessons and other skills that peer educators receive additionally. This implies abandoning the 
peer educator camps as second camps, as they exist today. It is very difficult to imagine this 
strategy, given the immense success of the present peer educator cells. However, it could be 
viewed as the creation of a more extensive peer unit. 
There are two observations worth highlighting here. First, I observed adolescents who were 
indeed anti-social transformed to the extent where they competed with friendly, nicer 
personalities. It may just be that the Peer Links training is so powerful that a larger army than the 
selected elite could have been involved. Second, whilst the persons with the obvious leadership 
qualities were very effective, it was found that the quality of the experience could not be 
guaranteed in this way. Sometimes peer educators failed to network the most vulnerable on the 
grounds that they did not understand how to reach these persons. Personally, I was more 
impressed by the case studies of completed change than by those who achieved large numbers of 
networks. I suggest that the acme of peer education is to train youth from each group to reach the 
most vulnerable in those cohorts. This is what explains why the boys from the gangs were able to 
return and recruit other gangsters to begin a peace process. None of these boys were peer 
educators, and they needed not to be. 
The Pre-puberty Dilemma 
In a country where services for children are less than effective and mostly out of reach for the 
most vulnerable pre-puberty children, where will Youth.now, with it’s 10 to 19 age frame, stand 
and how will it act in the future? I suggest that it will soon be impossible for the project not to 
intervene into the lives of the younger children. Fifty-eight boys of the sample reported they had 
had sexual intercourse. Of this number, 41 percent had their sexual debut between 5 and 10 
years. None, understandably, used a condom. Medical anthropologists have been suggesting that 
in areas where adolescents are among the top most HIV infected, including Jamaica, special 
attention needs to be focussed on the matter of early sexual debut. Will the project’s position be 
42 
that of collaboration with those agencies that work with younger children, or will it join in 
spearheading solution-oriented programmes for this vulnerable age? At least I suggest that 
Youth.now work with the Ministry of Health to evaluate the present programmes in primary 
schools and to see how students at this stage can be best made to understand matters of 
reproductive health. 
The Role of Parent Substitute 
It was quite depressing to see parents listed as a third and fourth source of quality information in 
adolescent reproductive health. Whilst on one hand it was good to hear that peer educators were 
more effective in getting their friends to begin using condoms every time, on the other hand it 
shouts to us that part of this intervention should be to remind parents of their responsibility, and 
this means equipping them. I applaud the recent parent initiative and suggest that it be expanded 
and handed to an agency in the parish for sustenance. It was very worrying that more than half of 
the fathers were absent from the households studied. Father-and-son and also father-and￾daughter, initiatives need to surface. Interestingly, most parents we met seemed equally in need 
of help. Not only can they act out of ignorance to hinder the progress of Youth.now, especially 
insecure fathers, but also many parents in Westmoreland were still within childbearing age and 
were themselves vulnerable of contracting HIV. 
Non-Political Stance 
Youth.now enjoys fluid movement throughout Jamaica because of its political non-alignment. In 
Westmoreland, many persons expressed they were happy it was not a tool of deceptive politics. I 
strongly suggest that this independent stance remain unchanged. 
43 
________________________________________________________________________ 
__________________________________________________ 
APPENDIX 
Westmoreland Adolescent Reproductive Health Evaluation Instrument 
Did you attend any of the Youth.now camps? Yes _________no________ 
(If he/she did) Which camps? April 2003 ______, July 2003_____, August 
_____Other____________ 
Personal Data 
Sex: _________ 
Age: _________ 
Grade/highest grade reached in school ____________ 
What kind of grades do you get in school (Include best and worst subjects) 
Tell me a bit about the family members in your household/yard. 
Persons in 
household/relation 
to respondent (sex if 
needed esp. cousins) 
Age of 
household 
member 
Economic 
activity 
Ranking of 
closeness to 
respondent 
Which of these persons is the head/ in charge of the household? 
44 
________________________________________________________________ 
________________________________________________________________ 
Are there any adults outside the household with whom you are close? (Who?) 
Where do you normally get spending money? 
Do you work to obtain money? (What do you do to earn money?) 
Things done to earn money Who is the employer/beneficiary of the service(s) 
Say which of the following apply to your household 
Items Checklist & Remark 
Tap Water 
Electricity 
House Telephone 
Cellular Phone 
Television Only 
Television and Cable 
Computer 
Computer and Internet 
Radio 
Component Set/Entertainment System 
Refrigerator 
Coal Stove 
Kerosene Stove 
Gas Stove 
Electric Stove (including hot plate) 
Microwave 
Washing Machine 
Bed Shared (with whom) 
Own Bed 
Room Shared (with whom) 
No Vehicle 
Parents/ Relatives’ Vehicle (what car) 
My Own Vehicle 
Pit Latrine 
Inside Flush 
Outside Flush (shared with neighbours) 
Tenement 
45 
Rented House 
Family Own House 
# of Bedrooms in House 
Community Setting 
How often do you experience the following in your community? 
OCCURRENCES FREQUENCIES 
Never Rarely Every 6 Every 3 Every Every Daily 
Months Months Month Week 
Neighbours quarrelling 
Women fighting 
Men fighting 
Children fighting 
See a child flogged 
Parents use swear words 
to children 
Child injured by an adult 
See/hear of girl/boy 
raped 
See/hear neighbour 
having sex 
See/hear family 
members having sex 
Someone stabbed 
Someone shot by police 
Someone shot by 
gunman 
Someone beaten 
by a group 
Someone punished by 
Don 
Someone’s house 
burnt by others 
46 
Tell me about the relationships between you and your closest friends. 
Friend 1 Friend 2 Friend 3 
Pet/Nickname 
Age 
Community 
School 
Things they talk 
about 
Things done 
together 
Reproductive Health 
Give a score out of 10 to each of the following in terms of how important these things are to you: 
Issues Score 
Food 
Being able to express feelings and opinions to boy/girlfriend 
Having a boy/girlfriend that is caring 
Hugging and holding hands 
Giving and receiving gifts 
Having a large penis/ boyfriend having a large penis 
Being known as a “wuckaman” or having a “wuckaman” boyfriend 
Having more than one sexual partners 
Loving someone before having sex 
Delaying sex until I have completed secondary school 
47 
Can you give some arguments for and against having sex during teenage. 
For Against 
What did the following mean to you before Camp and have those meanings changed? 
(For control and network ask: What do the following mean to you? Put under “before” section) 
Matters of Importance Before Youth.now Camp After Youth.now Camp 
Being a boy/male 
Being a female 
Having a child 
Having a boy/girlfriend 
Having sex 
Right age to begin having 
sex 
Becoming an adult 
Being a teenager 
Can you list some organs of the male and female’s body that is important in reproduction? 
Male _________________ 
Female ____________________ 
48 
___________________________ 
_______________ 
____________________________________________________________________ 
____________________________________________________________________ 
____________________________________________________________________ 
______________________ 
_____________________________________________________________________ 
_______________________________________ 
________________________________________________________________________ 
Have you ever had sexual intercourse? (Full or partial penetration by another) 
How old were you when you first had sex? 
What were the circumstances surrounding this first sexual experience?
(Was in love; could not wait; thought it was the right time; needed money; was forced; peer 
pressure; parents not at home) 
Did you use a condom the first time you had sex? Why? Why not? 
Did you/ (Boy) the girl use the pill or any other form of contraceptive the first time you had sex? 
Which contraceptive? 
How many of the following kinds of relationships have you had/still have? 
(Use only “before” section for control and network) 
Quality Before Youth.now Camp Since Youth.now Camp 
No sex involved 
No sex yet, but promised 
Serious/committed 
Casual/for fun 
For money only 
How often do you have sex now (times per week/month/quarter)? 
Do you have a steady partner now? If so tell me a bit about him/her. 
(Probe for age, background: marital status, class, area of residence etc.) 
49 
____________ 
___________________________________________ 
How many sexual partners do you have now? 
How often do you use condoms? ____________________________ 
On what occasions do you not use condoms? 
50 
(The following questions are quite intimate. They are very important though. I hope you do not 
mind). 
Sexual Activities Before Youth.now 
Camp 
After Youth.now 
Camp 
Comments regarding 
change of 
attitude or behaviour 
Masturbation 
Kiss a girl/woman 
Kiss a boy/man 
Fondled a girl/woman 
Fondled a boy/man 
Oral sex with a 
girl/woman 
Oral sex with a 
boy/man 
Sexual intercourse 
with a female 
Sexual intercourse 
with a male 
Anal sex with a 
female 
Anal sex with a male 
Sex with 2 or more 
persons 
Run battery on a girl 
Run battery on a boy 
51 
Contraception and STIs 
List as many methods of contraception as you can: 
1. 
2. 
3. 
4. 
5. 
6. 
7. 
List as many STIs as you can remember. 
1. 
2. 
3. 
4. 
5. 
6. 
7. 
Can you tell us some general signs and symptoms or things that people can notice when they 
contract an STI? 
1. 
2. 
3. 
4. 
52 
What do you know about HIV/AIDS? 
1. 
2. 
3. 
4. 
5. 
Do you know how to prevent contracting HIV? (List three ways.) 
1. 
2. 
3. 
Do you think that you are likely to contract HIV? 
Degree of 
Likelihood Reason given for degree of likelihood 
Very likely 
Likely 
Not certain 
Not likely 
Impossible 
53 
_________________________ 
__________________________ 
______________________________________ 
Please answer “true,” “false,” or “not sure,” to the following statements. 
Statement True False Not sure 
Douching or washing thoroughly after sexual intercourse 
is a good way of guarding against getting an STI 
Dirty looking people and those with bumps/pimples are 
more likely than clean looking people to have an STI 
A person can have an STI and have no sore or wart or any 
such signs on the genitals 
Latex condoms with spermicide are not different from 
regular condoms; they are just name brands. 
Children under the age of 12 are less likely than adults to 
get an STI if they have sex without using a condom 
You can get HIV the very first time you have sex 
Drinking a bottle of Pepsi immediately after sex helps to 
reduce the possibility of getting pregnant 
It is not possible to get HIV from unclean toilet seats. 
It is possible to get HIV if someone who has it sneezes, 
sweats, or cries on you 
If you contract an STI, it can make it easier for you to get 
another STI, including HIV 
It is quite easy to get the same STI more than once 
If a man has sex with a virgin it can help to cure his STI 
Pharmacists can legally refuse to sell condoms to someone 
who is under the age of 16 
Pregnancy 
Have you ever got a girl pregnant / been pregnant? 
How many times have you got a girl pregnant / been pregnant? 
Did you/she have the baby/babies? 
54 
_______________________________________________________________________ 
________________________________________________________________________ 
Did you ever have to abort a baby? _________________________________________ 
Why did you have to? 
Who looks after the baby/babies? 
Personal Information on Children 
Personal Information Child # 
1 2 3 4 
Name of child 
Mother of child 
Father of child 
Age of child 
Sex of child 
School attended 
Who child resides with 
Support for child 
Reproductive Health Services 
Listing and scoring of sources of sex education and family life 
Sources of information on Rate out of 10 to show 
sex and family life importance or impact on 
reproductive life 
Doctor 
Nurse 
Clinic 
Guidance counsellor 
Class teacher 
Youth.now camp 
Parents 
Grandparents 
Guardian: non-relative 
Public forum 
Television 
Cable 
55 
________________________________________________________________________ 
________________________________________________________________________ 
Internet 
Friends 
Community leader 
Church leader/pastor 
Sibling: brother or sister 
On the street 
Where do you get your condoms/contraceptives? 
How easy is it for you to get condoms/contraceptives? 
Can you list some things you can do to ensure that condoms do not slip or break? 
1. 
2. 
3. 
Verbal, Physical and Sexual Abuse 
Have you ever been verbally, physically or sexually abused? _______________________ 
Abuser Verbal Physical Sexual Frequency/ 
Degree 
Reasons for 
Abuse 
Parents 
Sexual 
partner/s 
Teacher 
Schoolmates 
Stranger 
Community 
person 
Sibling 
Police 
56 
Health 
provider 
Youth.now 
staff 
Self Concept and Life Chances 
Which of the following best describes your role model? 
Reason for Selection 
Role Model 
Parents 
Teacher 
Pastor 
Movie star 
Entertainer 
Don 
Other 
Which of the following best describes the group that you are in at present? 
Group Reasons for being in group 
Church choir 
Key Club 
Circle K 
Youth club 
Red Cross 
Brownies 
Cadet 
Brethren 
Girl’s Man Crew 
Girl’s Crew 
Dance/Fashion/ 
Culture Group 
Street youth 
(hustle) 
Corner crew 
Gang 
57 
________________________________________________________________________ 
________________________________________________________________________ 
________________________________________________________________________ 
________________________________________________________________________ 
______________________________________________________________________ 
________________________________________________________________________ 
________________________________________________________________________ 
_______________________________________________________________________ 
_______________________________________________________________________ 
How would you describe yourself? 
If you were to give yourself a rating out of 10 what would it be? 
Why that number/rating? 
How would you describe your life chances? 
Life Possibilities Reason for Selection 
Excellent 
Very good 
Good 
Possibilities 
Slim 
Poor 
What do you need most urgently to achieve your life’s goals? 
How has Youth.now’s programme impacted on your life? 
58 
_______________________________________________________________________ 
________________________________________________________________________ 
What would you like to see improved in the Youth.now programme? 
59