1. The Fourth ‘S’
A Survey of Tourists’ Sexual Attitudes and Behaviour While on Vacation in Barbados: A collaborative project between the Ministry of Tourism and the Ministry of Health

2. How did it start?
Ensuring that tourism related areas for HIV prevention activities in the National Strategic Plan are addressed
The need to assess client groups of Sex Workers and persons who engage in transactional sex
Tourists, tourism-related formal and informal sex work , clients of SWs were among the groups highlighted among the priorities in the NSP

3. Precedence
Similar studies have been completed in the following countries:
Ibiza (Spain) (Bellis, 2000)
Tenerife (Canary Islands) ( Batalla-Duran, 2003)
Hong Kong (Adullah, 1998)
Bellis (2000) Ibiza Uncovered: changes in substance abuse and sexual behaviour amongst young people visiting an international night-life resort International Journal of Drug Policy Vol.11 Issue 3
(Batalla-Duran, 2003) Sun, sea and sex? Sexual Behaviour of people on holiday in Tenerife
Family Practice Vol.20 No.4
(Adullah 1998) Travel, Sexual behaviour and the risk of contracting sexually transmitted diseases
Hong Kong Medical Journal vol.4 no.2

4. And within the Caribbean….
The Dominican Republic (Forsythe, 1998)
(Sanchez- Taylor, 2001)
The Bahamas & Jamaica (Boxill, 2005)
Research on the sexual behaviour of tourists in the Caribbean has been conducted in areas where sex tourism is known to exist. The extent to which this occurs in Barbados will be assessed, with an aim to doing further research among that category of tourist, to ensure that all categories of tourist will engage in safer sex practices. Barbados is the first in the Eastern Caribbean to undertake this type . Ethics in sexual research -Use of self-administered questionnaires, to reduce intrusion to study participants
Ensuring confidentiality through anonymous surveys.
Informed consent: study participants are provided information on the study and the use of the information they will provide
(Forsythe, 1998) Protecting paradise: tourism and AIDS in the Dominican Republic
Health Policy & Planning Vol 13 issue3
(Sanchez Taylor, 2001) Dollars are a girl’s best friend? Female Tourists’ Sexual Behaviour in the Caribbean
Sociology vol.35 no.3
(Boxill, 2005) Tourism, HIV&AIDS in Jamaica and the Bahamas

5. Rationale – A Tourist Study?
Lack of empirical data on the linkage between HIV and tourism
Tourists interact with a number of individuals while on vacation:
Tourism sector workers
Beach-based informal tourism workers
General retail & service sector workers
The correlation (between tourism, HIV & STI transmission) is inferred in several international review articles:
Tourism sector workers: {Hotels, guesthouses/villas. Entertainment venues, tourist attractions etc}
Beach-based informal tourism workers: {water sports operators, vendors, beach hustlers etc.}
Retail & service sector workers
Tourist arrival sexual contact? Establish who? when, where? How?
What do we need to know?
-Who? Profile of tourists – age, sex, purpose of visit etc.
-What? Sexual behaviour?, drug/alcohol use?
-Where? Meeting places, partners
-When? Expectations

6. Objectives
To identify the specific vulnerabilities and risk behaviour of tourists with respect to STI and HIV transmission
Examine and explore the sexual attitudes and practices of tourists in Barbados with respect to STI and HIV transmission

7. Objectives (cont’d)
To design and formulate appropriate targeted HIV and STI prevention interventions
Identify appropriate strategies that could be utilized to address this at-risk behavior
To ensure that current resources are channeled in a targeted and strategic fashion to minimize the transmission of STIs and HIV

8. The Process Identification of research areas
Selection of Methodologies: Sampling and Research Methodologies
Conducting of data gathering activities during High and Low Seasons, to make a comparison of varying categories of tourists.

9. Methodology Questionnaire was developed to gather information on:
Social demographics: Work, education, age, ethnicity, sex
Visiting patterns to Barbados
Sexual attitudes and behaviour
Views and ideas about new initiatives that can be developed to meet their sexual and reproductive health needs
Special thanks to our team of field investigators who undertook data gathering activities in a timely and efficient way.

10. Methodology
January, 2009 pilot survey of 50 questionnaires distributed to a random sample of tourists along south coast beaches.
Tourists were screened to ensure that they were on the island for over one night and up to three months, and also over 18 years old.
Questionnaire was revised and amended after a debriefing session with fieldworkers
February – March & August – October self-administered questionnaires were distributed to a random sample of tourists along the tourist belt e.g. South Coast, West and East coasts
Special thanks to our team of field investigators who undertook data gathering activities in a timely and efficient way.

11. Methodology
Integrated programme with members of the tourism sector, to ensure holistic approach to future prevention activities
Structured M&E programme to ensure the effectiveness of the activities
Special thanks to our team of field investigators who undertook data gathering activities in a timely and efficient way.

12. Future Steps…..
In-depth interviews among the target population and tourism related sector personnel
Compilation of the quantitative & qualitative data
Instituting strategic, targeted interventions based on the study findings
Next stage
In depth interviews: range of tourism stakeholders (tour operators, hotel management etc), governmental policymakers, tourism-related private sector workers etc.
After data is analysed and compiled. Feedback to tourism & health stakeholders re: findings and collaboration for next steps Eg. intervention development and implementation.

13. Implications for programming & policy
Strategic information to be utilised in the development of tourism policy, programme planning including tourism HIV prevention interventions/models
Integrated programme with members of the tourism sector, to ensure holistic approach to future prevention activities
Structured M&E programme to ensure the effectiveness of the activities

14. Future Research Tourism-related opportunistic sex work
What risk? Perceptions of risk and vulnerability among tourism sector workers

15. Thank you!!