Adolescence is a time of opportunity; however, for some it is also a time that leads to the narrowing of life options. For the 30% of the population in the English-speaking Caribbean who are adolescents and youth, sexual development occurs against a backdrop of regional instability and numerous challenges to health and development. Approximately one-third of adoles- cents in this region have had sexual intercourse, with many debuting at early ages; on average, boys at age 11 and girls at ages 14 –15 [1–7]. Moreover, studies report that among adolescents who are sexually active, one-third have had multiple sexual partners in the past year, 90% have used condoms, but only
16%–25% have used them consistently, and approximately half of those who are sexually active reported that their first sexual intercourse was forced [1–3].