How the Illicit Drug Economy Contributes to HIV Risk in St Vincent and the Grenadines.

St Vincent and the Grenadines (SVG) is the largest marijuana producer in the Eastern Caribbean. As the European Union has phased out preferred access for its banana crop, marijuana has become one of the main sources of income and a safety net for many young men, in particular. HIV is a problem for youth in SVG where 60% of the population and 50% of cumulative AIDS cases are among individuals under 30 years of age. To explore the relationship between the economic context and HIV, we used rapid appraisal methods including field observations, interviews, and focus groups with 43 key informants. We found that the marijuana-related economy has contributed to social conditions favoring HIV transmission among young people in several interrelated ways. A lively youth culture exists which includes frequent parties, heavy drinking, sex with multiple partners, and the desire to be seen with the best material goods. Men with access to money are able to attract younger partners for parties and sex. Condoms are infrequently used. We conclude that reducing HIV risk will require structural interventions to reduce discrimination and increase economic opportunity.