School is compulsory through age 16 and literacy rates are high. English is universally spoken, although a small proportion of adults are primarily Creole-speaking. 2Overall, 99% of children attending public high school in New Providence (the most populated island and location of Nassau) are of African descent (Personal communication, MOE). Although the per capita GNP is $16 140, wealth in the country is highly skewed, with the small population of affluent residents controlling most of the wealth. 1, 2Īpproximately 85% of the estimated 323 000 Bahamians are of African descent including the estimated 10% Creole population.
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It remains part of the British Commonwealth. The ~700 islands and cays (ie, small reefs or sandy islands of low elevation) constituting The Bahamas has been an independent nation since 1968. The Bahamas has a complex heritage, defined significantly by the indigenous Lycayan Indians and their subsequent enslavement by Spanish colonialists, the arrival of British settlers in 1648, and its role as a major link in the African slave trade until the abolition of slavery when it served as a safe-haven for escaping US slaves. This article describes the context in which the epidemic occurred, events leading up to the collaboration and the issues, decisions, processes, and relationships that we have developed that have allowed it to succeed. The programs have been shown to be effective.
FOCUS NASSAU TRIAL
The US-Bahamian team evaluated these interventions through a randomized, controlled 3-celled longitudinal trial (36 months follow-up) involving 15 elementary schools in The Bahamas. Caribbean Informed Parents and Children Together (CImPACT) emphasizes the importance of parent-child communication about sexuality and Goal for It” (GFI) emphasizes the importance of planning ahead. Two programs including a video and parent discussion were developed for their parents.
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A partnership developed which has spanned over a decade and led to the development of an intervention program targeting Bahamian children in grade six, a 10-session adolescent HIV prevention program entitled “Focus on Youth in the Caribbean” (FOYC). The intervention, “Focus on Kids,” (FOK) was effective in reducing risk behaviors, intentions, and perceptions and ultimately was included in the Center for Disease Control’s portfolio of effective adolescent programs, “Programs that Work.” Learning about FOK and concerned about the need for a structured program to address high rates of teen pregnancy and risk for HIV, professionals from the Ministries of Health of The Bahamas approached the researchers about collaborating to develop a program for Bahamian youth. In the 1990s, an interdisciplinary group including pediatricians, anthropologists, health educators, psychologists, and statisticians developed and evaluated an HIV prevention intervention targeting early adolescents living in public housing developments in the USA.