Eworth Williams, a Guyanese youth pastor and teacher, isn't shocked by the stories he hears. The people who come to his "Sex in the Church" meetings, however, are often stunned. On Sunday afternoons, a few hours after services have wrapped, members from about seven congregations come together for a wake-up call.
"Most parents don't even know what is happening in schools and in the church," Williams says. "There are rainbow parties where the ladies wear lipstick and give the guys oral sex. The guy with the most colours on his penis wins. Even anal sex has crept in. They say they want to keep their virginity for their husbands so they have sex in the butt."
Here he stops to make what must be a routine check in his line of work: "Are you okay with me discussing these things? Some people aren't.
Pastors don't want to talk about sex in church. They only want to talk about righteousness, peace and God. They don't want to address the issue from the pulpit but young people are going out there now for the answers."
In Trinidad, Merle Ali and her husband, Pastor Hasratt Ali, are part of the vocal minority.
Throughout the year they conduct HIV sensitisation sessions with willing church communities. In the right context the registered nurse and midwife will even address correct condom use.
"Especially in the 1990s, there was the perception that that doesn't belong in the church, or that HIV is God's judgment on people. Some were in a state of denial and didn't believe the church was affected. There was a lot of resistance and even now there isn't that openness," Ali admits. "I have come across a lot of people living with HIV in Trinidad who are afraid to share that information for fear of being discriminated against."
Williams and the Alis are part of a growing movement in the Caribbean evangelical community to dialogue honestly about sex and HIV. In some places the opening to have these conversations came from a unique 2009 study.
"Survey of the sexual practices of youth attending Evangelical Churches in Antigua, St Lucia and St Vincent" asked probing questions of more than one thousand young church members—everything from how many sexual partners they've had to whether they use condoms.
Knowledge among the sample on how HIV is transmitted was found to be "surprisingly deficient" with 46.7 per cent of the church youth having been sexually active while 2.6 per cent said that they were HIV positive. (The Caribbean as a whole has an adult HIV prevalence of one per cent while Trinidad and Tobago's is 1.5 per cent.)
Bishop Gerry Seale, the Secretary General of the Evangelical Association of the Caribbean (EAC), piloted the approach in his native Barbados before attracting support from the UNICEF Barbados and Eastern Caribbean Office for the larger study.
"The message that's constantly projected is that the at-risk communities are gays, prostitutes and other persons the church feels are not their constituency. Once we saw the stats it helped me say to the evangelical church leaders that HIV is not about 'them' out there in the marginalised communities. It is about us," Seale says.
The study showed that while there was a spike in first sexual activity from ages 15 to 17, almost 200 respondents had sex at younger ages.
Behavioural Surveillance Surveys conducted by the Caribbean Epidemiology Centre (CAREC) and Pan American Health Organisation (PAHO) in six Organisation of Eastern Caribbean States (OECS) countries from 2005 to 2006 revealed that early initiation of sex and age mixing among young people are commonplace. According to the 2010 United National General Assembly Special Session (UNGASS) Country Progress Report for Antigua there was a threefold increase in reported cases of HIV among young people from 2008 to 2009 as compared to the previous two-year period. St Vincent's UNGASS report stated that HIV prevalence among young people is a high 2.5 per cent.
Seale insists that the church leadership has a moral responsibility to share "scientifically accurate and biblically sound information" about sex.
"The message I strongly give is that the Bible teaches abstinence and faithfulness within marriage. If you are going to step outside of those boundaries, for God's sake use a condom. The message for young people is abstinence. I do not share the pessimism that young people cannot abstain… but if you are going to choose not to abstain you need to use a condom," says Seale. "I don't see anything controversial about that."
Starting this conversation has made a wide range of approaches possible. In March 20 young people from four Caribbean countries were taught life skills like communication and decision-making and given training to share the information with others.
And Seale sometimes hosts workshops to address stigma in which congregations confront their prejudices during a role play exercise.
"We pick three persons and have a vote about who gets life-saving HIV drugs. One is gay, one works as a maid and the other works in an escort agency. The voting is usually based on stigma so we have a discussion about that," explains Seale.
Part of Williams' outreach is to share food, clothing and the church's message with gays and sex workers in the streets of Georgetown, Berbice and Essequibo.
"The scripture is filled with the language that is needed in this AIDS crisis," Ali says. "The very guiding principles for life that Jesus lived and taught were of love, compassion and no discrimination. He touched the leper. He did not spurn the woman at the well. We too must love unconditionally."
Joint United Nations Programme on HIV/AIDS (UNAIDS) Caribbean Regional Support team director, Ernest Massiah, says that faith-based organisations are a key constituency in the Caribbean's HIV response.
"Faith-based communities involve large segments of the population. We need to see what opportunities there are to dialogue, where they have been involved and where they feel they can effect change," Massiah says.
For more information on the study and the work of the Evangelical Association of the Caribbean please go to www.caribbeanevangelical.org