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Ojukwu EN, Okoye HU, Saewyc E. Social Correlates of HIV-Risky Behaviours among African Canadian Adolescents Living in British Columbia, Canada: A Secondary Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6031. [PMID: 37297635 PMCID: PMC10252849 DOI: 10.3390/ijerph20116031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 06/12/2023]
Abstract
Studies have linked HIV-risky behaviours among young people to several socio-contextual factors. However, the social factors that might increase African Canadian adolescents' exposure to HIV-risky behaviours, including unprotected sex and forced or multiple-sexual partnerships, have received little or no attention in the literature. Using data from the British Columbia Adolescent Health Surveys (2003-2018) and guided by intersectionality and socio-ecological frameworks, we examined the social determinants of HIV-risky behaviours (HRB) among African Canadian adolescents in British Columbia. We observed a general decline in HRB from 2008 to 2018. However, more than half (54.5%) of the 1042 who were sexually experienced in 2018 reported having 2 or more sexual partners, and nearly half reported condom-less sex. Our results demonstrate an important need to evaluate the impacts of several social factors on health outcomes for a unique, marginalized population.
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Das U, Rout S. Are delay ages at marriage increasing? Pre-marital sexual relation among youth people in the place of residence in India. BMC Womens Health 2023; 23:16. [PMID: 36631806 PMCID: PMC9835306 DOI: 10.1186/s12905-022-02149-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/26/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Adolescent sexual and reproductive health is a major public health issue throughout the world. At the same time shifting of marriage are undergoing discernible changes in country like India. This paper attempts to examine the effect of delay age at marriage on the risks of pre-marital sexual intercourse for the youth people in the place of residence. METHODS Data used in the present study is from various annual publications of Sample Registration System (SRS) and four round of National Family Health Survey, which was conducted in 2015-2016. The Kaplan-Meier life table technique and multivariate regression models are used to examine the premarital sex by the place of residence and marriage cohort. RESULTS Findings of the study indicate that the reasons underlying delayed marriage differs between blow 21 years age group and 22-30 years age group. Multinomial analysis clearly shows education, wealth quintile and mass media are major controlling factors of delayed age at marriage. Residing in urban adolescent women who belonged to better economic family background and exposed to mass media had a higher probability to experience premarital sexual intercourse than the rural adolescent in delay age group. CONCLUSION The study concludes that the restorative the empowerment of youth especially for women and health care provider should consider a multidimensional approach for higher education among youth people and safe sexual behaviour in pre-marital sexual intercourse.
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Affiliation(s)
- Ujjwal Das
- grid.444315.30000 0000 9013 5080P.G. Department of Geography, Fakir Mohan University, Balasore, Odisha India
| | - Sasmita Rout
- grid.444315.30000 0000 9013 5080P.G. Department of Geography, Fakir Mohan University, Balasore, Odisha India
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Giacci E, Straits KJ, Gelman A, Miller-Walfish S, Iwuanyanwu R, Miller E. Intimate Partner and Sexual Violence, Reproductive Coercion, and Reproductive Health Among American Indian and Alaska Native Women: A Narrative Interview Study. J Womens Health (Larchmt) 2022; 31:13-22. [PMID: 34747659 PMCID: PMC8785763 DOI: 10.1089/jwh.2021.0056] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: The disproportionately high prevalence of poor reproductive and sexual health outcomes among American Indian and Alaska Native (AI/AN) women is related to histories of colonization, oppression, and structural racism. Intimate partner violence (IPV) and sexual violence (SV) contribute to these health outcomes. Materials and Methods: Narrative interviews were conducted with AI/AN women from four tribal reservation communities. Interviews explored connections among sexual and reproductive health, IPV, SV, reproductive coercion (RC), and pregnancy experiences as well as women's experiences of healing and recovery. Results: Among the 56 women interviewed (aged 17-55 years, 77% were aged 40 years and younger), all described multiple exposures to violence and highlighted lack of disclosure related to sexuality, childhood abuse, SV, and historical trauma. Access to confidential reproductive health services and contraceptive education was limited. Almost half (45%) reported experiencing RC in their lifetime. Use of substances occurred in both the context of SV and for surviving after exposure to violence. Women underscored the extent to which IPV, SV, and RC are embedded in histories of colonization, racism, and ongoing oppression. Interventions that incorporate AI/AN traditions, access to culturally responsive reproductive health and advocacy services, organizations, and services that have AI/AN personnel supporting survivors, public discussion about racism, abuse, sexuality, and more accountable community responses to violence (including law enforcement) are promising pathways to healing and recovery. Conclusions: Findings may advance understanding of AI/AN women's reproductive health in the context of historical trauma and oppression. Intervention strategies that enhance resiliency of AI/AN women may promote reproductive health.
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Affiliation(s)
- Elena Giacci
- Advocate and Training Specialist (Dine), Albuquerque, New Mexico, USA
| | - Kee J.E. Straits
- Tinkuy Life Community Transformations, LLC, Albuquerque, New Mexico, USA
| | - Amanda Gelman
- Chinle Comprehensive Health Care Facility, Chinle, Arizona, USA
| | - Summer Miller-Walfish
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rosemary Iwuanyanwu
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Hackett L, Biderman M, Doria N, Courville J, Bogner E, Spencer R, Miller D, McMillan J, Numer M. A rapid review of Indigenous boys' and men's sexual health in Canada. CULTURE, HEALTH & SEXUALITY 2021; 23:705-721. [PMID: 32223538 DOI: 10.1080/13691058.2020.1722856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 01/24/2020] [Indexed: 06/10/2023]
Abstract
Indigenous boys and men in Canada face adverse social and structural circumstances that affect their ability to achieve and maintain sexual health. Research about Indigenous sexual health, however, is largely limited to matters relating to women and statistics on sexually transmitted infections. A rapid review of research was conducted to determine what is currently known about Indigenous boys' and men's sexual health in Canada. Given the prevalence of research documenting quantitative disparities, the current review included qualitative research only. Thirteen included studies explored a wide range of topics relating to sexual health and an overarching intersection between social conditions and individual health outcomes was observed. The results of this review reveal significant gaps in the literature relating to the holistic sexual health of Indigenous boys and men and highlight important domains of sexual health to consider in future research. Findings suggest that sexual health programmes that promote traditional Indigenous knowledge and intergenerational relationships may be effective for promoting sexual health among Indigenous boys and men.
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Affiliation(s)
- Lisa Hackett
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Maya Biderman
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Nicole Doria
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Julien Courville
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Emma Bogner
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Rebecca Spencer
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | | | - Jane McMillan
- Department of Anthropology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Matthew Numer
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
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Singh SK, Vishwakarma D, Sharma SK. An Epidemiology of Premarital Sexual Behaviour in India: Exploring Gender Differences. JOURNAL OF HEALTH MANAGEMENT 2020. [DOI: 10.1177/0972063420937938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article analyzes the social context of increasing premarital sex in India in a gender perspective, which affects the overall contexts, patterns and the characteristics of premarital sexual behaviour. The study has been conducted on data collected from 169,814 unmarried women and 40,003 unmarried men, a part of the Indian Demographic Health Survey (DHS), 2015–2016. Gender differences in premarital sex were pronounced, where unmarried men were five times more likely to have premarital sex (16%) as compared to unmarried women (3%). Cox regression portrays that both men and women at younger ages were significantly more likely to initiate premarital sex. Muslim men were significantly more likely (HR = 1.16 times) to have premarital sex at younger ages. Regional variations in the prevalence of premarital sex are pronounced. Findings reveal that unmarried women with higher education, residing in urban areas and who belong to richest wealth quintile and exposed to regular mass media were more likely to have multiple sexual partners in premarital sex. There is a striking regional variation in the low prevalence of condom use in the premarital sex reported by unmarried men as well as women. In fact, unmarried men were more likely to use condom in their first as well as last premarital sexual encounter than their women counterparts. Findings suggest strengthening the empowerment of youth, especially women, through enhancing their reproductive and sexual rights education and promoting safe sexual behaviour in premarital sexual encounters.
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Affiliation(s)
- Shri Kant Singh
- International institute for Population Sciences, Mumbai, Maharashtra, India
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Logie CH, Lys CL, Fujioka J, MacNeill N, Mackay K, Yasseen Iii AS. Sexual practices and condom use among a sample of Northern and Indigenous adolescents in Northern Canada: cross-sectional survey results. BMJ SEXUAL & REPRODUCTIVE HEALTH 2018; 45:bmjsrh-2018-200174. [PMID: 30591551 PMCID: PMC6579555 DOI: 10.1136/bmjsrh-2018-200174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/26/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Sexually transmitted infections (STI) prevention in the Northwest Territories (NWT), Canada is an urgent concern as STI prevalence is seven-fold the national average. The study objective was to explore factors associated with sexual activity and condom use among adolescents in the NWT. METHODS We conducted a cross-sectional survey with youth aged 13-18-years-old in 17 NWT communities. We use Poisson regression models with a robust sandwich error variance to estimate adjusted relative risks estimates of the likelihood of experiencing the primary outcomes of sexual activity (vaginal/anal/oral sex) and consistent condom use (oral/anal sex) in the past 3 months by gender. RESULTS Participants (n=607; mean age: 14.2 years; SD: 1.5) included adolescent cisgender girls (n=302; 49.5%), cisgender boys (n=298; 48.9%) and transgender persons (n=7; 1.2%). Most identified as Indigenous (n=444; 73.1%) and 14.0% (n=85) as lesbian, gay, bisexual or queer sexuality (LGBQ+). Among sexually active individuals (n=115), less than half (n=54; 47.0%) reported past 3 month consistent condom use. In adjusted analyses among girls, sexual activity was associated with age, STI knowledge, and alcohol/drug use; LGBQ+ identity and alcohol/drug use were associated with reduced likelihood of condom use. Among boys, sexual activity was associated with age and alcohol/drug use; LGBQ+ identity was associated with increased likelihood of condom use. CONCLUSIONS Findings demonstrate sexual activity among adolescents in the NWT varies by gender, age, and alcohol/drug use. Consistent condom utilisation was low, particularly for those using alcohol/drugs. Gender-tailored STI prevention strategies with Northern adolescents should address alcohol/drug use and build protective factors.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Candice L Lys
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
| | - Jamie Fujioka
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Nancy MacNeill
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
| | - Kayley Mackay
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
| | - Abdool S Yasseen Iii
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Clark N, Walton P, Drolet J, Tribute T, Jules G, Main T, Arnouse M. Melq'ilwiye: Coming Together — Intersections of Identity, Culture, and Health for Urban Aboriginal Youth. Can J Nurs Res 2017; 45:36-57. [DOI: 10.1177/084456211304500208] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Rand JR. Inuit women's stories of strength: informing Inuit community-based HIV and STI prevention and sexual health promotion programming. Int J Circumpolar Health 2016; 75:32135. [PMID: 27938640 PMCID: PMC5149655 DOI: 10.3402/ijch.v75.32135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/05/2016] [Accepted: 09/27/2016] [Indexed: 11/23/2022] Open
Abstract
Background There is a dearth of literature to guide the development of community-based HIV and sexually transmitted infection (STI) prevention and sexual health promotion programs within Inuit communities. Objective The aim of this study was to create a dialogue with Inuit women to address the lack of information available to inform programming to improve the sexual health of Inuit women, their families, and their communities in the Canadian Arctic. Design This study used Indigenous methodologies and methods by drawing from Inuit Qaujimajatuqangit and postcolonial research theory in a framework of Two-Eyed Seeing, and using storytelling sessions to gather data. Community-based participatory research principles informed the design of the study, ensuring participants were involved in all stages of the project. Nine storytelling sessions took place with 21 Inuit women aged 18–61 years. Storytelling sessions were audio recorded and transcribed verbatim, and Atlas.ti aided in the organization of the data for collaborative thematic analysis within three participatory analysis sessions with 13 of the participating women. Results From the storytelling and analysis sessions, five major themes emerged: (a) the way it used to be, (b) change, (c) family, (d) intimate relationships and (e) holistic strategies. Participating women emphasized that HIV and STI prevention and sexual health promotion programming needs to take a holistic, community-wide, family-focused and youth-centred approach within their communities. Conclusion Participants identified several important determinants of sexual health and shared ideas for innovative approaches they believe will work as prevention efforts within their communities. This article specifically focuses on key characteristics of programming aimed at STI and HIV prevention and sexual health promotion that were identified throughout participants’ stories. This study has provided a narrative to complement the epidemiological data that highlight the urgent need for prevention programming.
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Affiliation(s)
- Jenny R Rand
- Interdisciplinary PhD Program, Faculty of Graduate Studies, Dalhousie University, Halifax, NS, Canada;
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Maticka-Tyndale E, Kerr J, Mihan R. A profile of the sexual experiences of African, Caribbean and Black Canadian youth in the context of Canadian youth sexuality. CANADIAN JOURNAL OF HUMAN SEXUALITY 2016. [DOI: 10.3138/cjhs.251-a1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Canadian studies have examined patterns of sexual behaviour and health based on age, gender, and geographical regions, but typically ignored the increasing ethnic diversity in Canada's population. In large part this is because sampling techniques tend to produce insufficient numbers of youth in specific ethnic groups for detailed analysis. This paper presents a profile of the sexual experiences of African, Caribbean, and Black (ACB) youth using data collected in a survey (n=510) with ACB youth age 16–25 years living in the Windsor/Essex County region of Ontario, Canada. Data were examined for differences among the three ethno-racial groups in combination with differences between Muslims and Christiana, and males and females. In this predominantly heterosexual sample (95%), nearly ¾ of the Black and Caribbean youth reported sexual intercourse experience compared to well under ½ of the African youth. Overall, African were less experienced than Caribbean and Black youth and, within the African group, Muslim less than Christian youth. This included age of initiating various sexual activities, number of partners, use of condoms, and experiences of either non-volitional or non-relational sex. Alcohol in connection with sexual activity and multiple partners within a single month were rare. The Black and Caribbean participants reported sexual experiences and had a sexual profile that was closest to that of Canadian youth. Given the increasingly multicultural profile of Canada, these findings support the importance of research on distinct ethno-racial groups in Canada to inform the delivery of sexual education and health policy and programming.
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Affiliation(s)
| | - Jelani Kerr
- Department of Health Promotion and Behavioral Sciences, University of Louisville, Louisville, KY
| | - Robert Mihan
- Department of Sociology, Anthropology, and Criminology, University of Windsor, Windsor, ON
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Rink E, Montgomery-Andersen R, Anastario M. The effectiveness of an education intervention to prevent chlamydia infection among Greenlandic youth. Int J STD AIDS 2014; 26:98-106. [PMID: 24713230 DOI: 10.1177/0956462414531240] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to implement a sexual health behavioural intervention in Greenland in order to reduce sexually transmitted infection rates among a population of Greenland youth. This behavioural intervention was called Inuulluataarneq (Having the Good Life). Inuulluataarneq's objects included: (1) increase Greenlandic youth's overall knowledge about sexually transmitted infections and sexual health; (2) increase parent/guardian-youth communication about topics related to sexually transmitted infections and sex; and (3) increase consistent condom use among Greenlandic youth. We hypothesised that increased awareness of sexually transmitted infections and sexual health as well as increased communication between parents/guardians and their adolescent children would influence sexual risk behaviour and reduce sexually transmitted infections among our sample population, with a focus on urine samples of chlamydia infection. Results indicate that the influence of having a parent/guardian to speak with about topics related to sex, including the consequences of pregnancy, are key protective factors in reducing sexually transmitted infections among Greenlandic youth. Inuulluataarneq demonstrates that intensive short-term education and skill-building delivered by a trained community member is an effective sexually transmitted infection prevention intervention method among young Inuit populations who live in small isolated Arctic communities.
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Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, MT, USA
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Minichiello V, Rahman S, Hussain R. Epidemiology of sexually transmitted infections in global indigenous populations: data availability and gaps. Int J STD AIDS 2013; 24:759-68. [PMID: 24052012 DOI: 10.1177/0956462413481526] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Socioeconomic and health disadvantage is widespread within and across indigenous communities in the world, leading to differentials in morbidity and mortality between indigenous and non-indigenous populations. Sexually transmitted infections (STIs), including HIV/AIDS, among indigenous populations are an emerging public health concern. The focus of this paper is on examining the STI epidemiology in indigenous communities in various parts of the world utilizing a range of data sources. Most of the STI research on global indigenous communities has concentrated on developed countries, neglecting more than half the world's indigenous people in the developing countries. This has resulted in major gaps in data at global level for STIs and HIV/AIDS among indigenous populations. Available data show that the prevalence of STIs is increasing among the indigenous communities and in several instances, the rates of these infections are higher than among non-indigenous populations. However, HIV still remains low when compared with the rates of other STIs. The paper argues that there is an urgent need to collect more comprehensive and reliable data at the global level across various indigenous communities. There is also an opportunity to reverse current trends in STIs through innovative, evidence-based and culturally appropriate targeted sexual health programmes.
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Affiliation(s)
- Victor Minichiello
- The Australian Research Centre in Sex, Health and Society, School of Public Health & Human Biosciences, La Trobe University, Melbourne, Australia
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Chavoshi N, Waters S, Moniruzzaman A, Richardson CG, Schechter MT, Spittal PM. The Cedar Project: sexual vulnerabilities among Aboriginal young people involved in illegal drug use in two Canadian cities. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2012; 103:e413-e416. [PMID: 23618018 PMCID: PMC6975203 DOI: 10.1007/bf03405628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 11/12/2012] [Accepted: 09/20/2012] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Very few studies in Canada address the sexual health of young Aboriginal people who use drugs; the focus in established literature has been on parenteral risks. This study sought to identify the risk factors associated with inconsistent condom use in a cohort of young Aboriginal people who live in British Columbia and use drugs. METHODS This analysis includes baseline questionnaire data from October 2003 to April 2005. Multivariable modeling stratified by gender identified independent demographic, traumatic, sex and drug use risk factors associated with inconsistent condom use. RESULTS Of the 292 women and 313 men at baseline, prevalence of inconsistent condom use during insertive sex was 59% and 46%, respectively. In multivariable logistic regression, after adjusting for age and location, inconsistent condom use among women was significantly associated with ever being enrolled in a drug/alcohol treatment program (AOR: 1.95, 95% CI: 1.06-3.60), and ever being sexually abused (AOR: 1.80, 95% CI: 1.01-3.20). Among men, inconsistent condom use was significantly associated with having more than 20 lifetime sex partners (AOR: 2.06, 95% CI: 1.24-3.44). CONCLUSION Our study demonstrates high rates of inconsistent condom use among young Aboriginal people who use drugs, highlighting their vulnerability to contracting sexually transmitted infections. Culturally tailored sexual health interventions must be made a priority and need to incorporate the reality of gendered differences in the context of multigenerational trauma, including non-consensual sex.
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Affiliation(s)
- Negar Chavoshi
- School of Population and Public Health, University of British Columbia, Vancouver, BC.
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Ning A, Wilson K. A research review: exploring the health of Canada's Aboriginal youth. Int J Circumpolar Health 2012; 71:IJCH-71-18497. [PMID: 22973569 PMCID: PMC3427595 DOI: 10.3402/ijch.v71i0.18497] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Revised: 07/20/2012] [Accepted: 07/21/2012] [Indexed: 11/15/2022] Open
Abstract
Objective To compare the current state of health research on Aboriginal and non-Aboriginal youth in Canada. Design A search of published academic literature on Canadian Aboriginal youth health, including a comprehensive review of both non-Aboriginal and Aboriginal youth research, was conducted using MEDLINE and summarized. Methodology A MEDLINE search was conducted for articles published over a 10-year period (2000–2010). The search was limited to research articles pertaining to Canadian youth, using various synonyms for “Canada,” “youth,” and “Aboriginal.” Each article was coded according to 4 broad categories: Aboriginal identity, geographic location, research topic (health determinants, health status, health care), and the 12 key determinants of health proposed by the Public Health Agency of Canada (PHAC). Results Of the 117 articles reviewed, only 34 pertained to Aboriginal youth, while the remaining 83 pertained to non-Aboriginal youth. The results revealed major discrepancies within the current body of research with respect to the geographic representation of Aboriginal youth, with several provinces missing from the literature, including the northern territories. Furthermore, the current research is not reflective of the demographic composition of Aboriginal youth, with an under-representation of Métis and urban Aboriginal youth. Health status of Aboriginal youth has received the most attention, appearing in 79% of the studies reviewed compared with 57% of the non-Aboriginal studies. The number of studies that focus on health determinants and health care is comparable for both groups, with the former accounting for 62 and 64% and the latter comprising 26 and 19% of Aboriginal and non-Aboriginal studies, respectively. However, this review reveals several differences with respect to specific focus on health determinants between the two populations. In non-Aboriginal youth studies, all the 12 key determinants of health of PHAC are explored, whereas in Aboriginal youth studies the health profile remains incomplete and several key determinants and health indicators are neglected. Conclusions The current studies are not reflective of the demographic and geographic profiles of Aboriginal youth in Canada, and they have also failed to provide a comprehensive examination of their unique health needs and concerns compared with studies on non-Aboriginal youth.
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Affiliation(s)
- Ashley Ning
- Department of Geography & Collaborative Program in Aboriginal Health, University of Toronto Mississauga, Mississauga, Canada.
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Homma Y, Wang N, Saewyc E, Kishor N. The relationship between sexual abuse and risky sexual behavior among adolescent boys: a meta-analysis. J Adolesc Health 2012; 51:18-24. [PMID: 22727072 PMCID: PMC4829388 DOI: 10.1016/j.jadohealth.2011.12.032] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 12/23/2011] [Accepted: 12/24/2011] [Indexed: 10/28/2022]
Abstract
PURPOSE Childhood and adolescent sexual abuse has been shown to lead to increased odds of sexual behaviors that lead to sexually transmitted infections and early pregnancy involvement. Research, meta-analyses, and interventions, however, have focused primarily on girls and young women who have experienced abuse, yet some adolescent boys are also sexually abused. We performed a meta-analysis of the existing studies to assess the magnitudes of the link between a history of sexual abuse and each of the three risky sexual behaviors among adolescent boys in North America. METHODS The three outcomes were (a) unprotected sexual intercourse, (b) multiple sexual partners, and (c) pregnancy involvement. Weighted mean effect sizes were computed from ten independent samples, from nine studies published between 1990 and 2011. RESULTS Sexually abused boys were significantly more likely than nonabused boys to report all three risky sexual behaviors. Weighted mean odds ratios were 1.91 for unprotected intercourse, 2.91 for multiple sexual partners, and 4.81 for pregnancy involvement. CONCLUSIONS Our results indicate that childhood and adolescent sexual abuse can substantially influence sexual behavior in adolescence among male survivors. To improve sexual health for all adolescents, even young men, we should strengthen sexual abuse prevention initiatives, raise awareness about male sexual abuse survivors' existence and sexual health issues, improve sexual health promotion for abused young men, and screen all people, regardless of gender, for a history of sexual abuse.
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Affiliation(s)
- Yuko Homma
- School of Nursing, University of British Columbia, Vancouver, Canada.
| | - Naren Wang
- Independent researcher, British Columbia, Canada
| | - Elizabeth Saewyc
- University of British Columbia School of Nursing, Vancouver, Canada,McCreary Centre Society, Vancouver, Canada
| | - Nand Kishor
- University of British Columbia Department of Educational and Counselling Psychology, and Special Education, Vancouver, Canada
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Bryant J, Ward J, Worth H, Hull P, Solar S, Bailey S. Safer sex and condom use: a convenience sample of Aboriginal young people in New South Wales. Sex Health 2011; 8:378-83. [PMID: 21851779 DOI: 10.1071/sh10138] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 03/28/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND This paper examines condom use in a sample of Aboriginal young people in New South Wales (NSW) aged 16-30 years. METHODS Cross-sectional data were collected using hand-held computer devices from 293 Aboriginal people attending two Aboriginal events in NSW. RESULTS Almost two-thirds of respondents reported having had a casual sex partner in the previous 6 months. Of these, 39.2% reported always using a condom with casual partners. Having always used a condom with casual partners varied among respondents, and was more likely among younger respondents (adjusted odds ratio (AOR): 2.7, 95% confidence interval (CI): 1.2-6.1) and less likely among those who used illicit drugs (AOR: 0.2, 95% CI: 0.1-0.7). CONCLUSIONS In comparison to published studies of other Australians, casual sex appears to be more common among this sample of Aboriginal young people; however, the proportion who report having always used condoms with casual partners is very similar. This suggests that although casual sex is more common, Aboriginal young people do not engage in risky behaviour any more often than other young Australians. Further work should be conducted with those who do not always use condoms, such as those who are older and who use illicit drugs, particularly with regards to how abstinence from drug use supports protective behaviours such as condom use among this population of Aboriginal young people.
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Affiliation(s)
- Joanne Bryant
- National Centre in HIV Social Research, University of New South Wales, Sydney, NSW 2052, Australia.
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Devries KM, Free CJ. Boyfriends and booty calls: sexual partnership patterns among Canadian Aboriginal young people. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2011; 102:13-17. [PMID: 21485961 PMCID: PMC6974215 DOI: 10.1007/bf03404871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 08/20/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Sexual partnership patterns, forced sex, and condom non-use can contribute to STI risk, but little is known about these patterns among Aboriginal young people despite elevated STI risk in this group. We describe sexual relationship and condom use patterns among Canadian Aboriginal young people, and how these patterns relate to the socio-structural context as experienced by young people. METHODS We use data from in-depth individual interviews conducted in 2004 with 22 young people who reported ever having sex and who self-identified as Aboriginal in British Columbia, Canada. A thematic analysis is presented. RESULTS Young people described a range of partnership patterns, including 'on-off' relationships which could have high rates of partner turnover but could sometimes be viewed as acceptable contexts for pregnancy, precluding condom use. Contextual elements beyond individual control appeared to contribute to these patterns. Migration between geographic locations was linked with risky partnership patterns, especially if it was linked with family instability or substance use problems. CONCLUSION Sexual health interventions for this group must address partnership patterns in addition to promoting condom use. Survey research into 'migration' as a risk factor for STI transmission should consider reasons for migration. Interventions that address both individual level behaviour and the contextual elements that shape behaviour should be developed and tested.
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Affiliation(s)
- Karen M Devries
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
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The unmet health needs of East Asian high school students: are homestay students at risk? Canadian Journal of Public Health 2010. [PMID: 20737818 DOI: 10.1007/bf03404382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Most "homestay" high school students come to Canada from East Asian countries such as China, Korea and Japan to attend school while living with another family. Our objectives were to examine: 1) the characteristics of homestay youth compared to immigrant and Canadian-born East Asian youth and 2) whether their health risk behaviours are similar to immigrant or Canadian-born East Asian youth. METHODS We used the 2003 British Columbia Adolescent Health Survey to examine characteristics of East Asian youth and their health risk behaviours, including sexual behaviours, substance abuse, abuse history, and health status. Homestay students were those not born or raised in Canada and not living with their parent(s) or in foster care. Multivariate models tested for the independent association of student group, controlling for age. RESULTS Homestay students (weighted n = 3,085) were older, on average, than immigrant or Canadian-born youth and spoke a language other than English at home (p < 0.001). Multivariate analyses showed that homestay students were more likely to engage in sexual behaviours than other youth and over 4 times more likely to have used cocaine. Female homestay students were 3 times more likely to be a victim of sexual abuse and were also 3 times more likely to use a substance prior to sex. CONCLUSION Homestay students remain a forgotten and extremely vulnerable group of youth, in part because they have special living arrangements. No one is currently held accountable for their health or safety. In the absence of health policy about homestay students, public health officials and providers have a central role in ensuring the former's health is not threatened.
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Devries KM, Free C. 'I told him not to use condoms': masculinities, femininities and sexual health of Aboriginal Canadian young people. SOCIOLOGY OF HEALTH & ILLNESS 2010; 32:827-842. [PMID: 20456685 DOI: 10.1111/j.1467-9566.2010.01242.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Gendered power imbalances in heterosexual relationships are a key target of gender-sensitive STI risk reduction interventions. Gendered aspects of sexual behaviour have not been explored among Canadian indigenous young people, who are at elevated risk for STI relative to other young Canadians. We used data from in-depth qualitative interviews with 15 male and 15 female indigenous young people to explore gendered sexual behaviour and its implications for STI reduction. There was a pervasive 'double standard' where young men were expected to be sexually aggressive and young women were expected to resist sexual advances; but we also observed 'alternative' or non-hegemonic behaviours. Specifically, young women were often very active participants in sexual negotiations, could refuse condom use and sometimes pressured their male partners to not use condoms. Young men also described being the object of coerced sex, and did not always perceive female sexual desire in negative terms, and were not always receptive to sex. The gendered sexual attitudes and behaviours in our sample were much more complex than usually described in the literature. Intervention work needs to take more realistic account of the sexual interactions that occur between young people.
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Affiliation(s)
- Karen M Devries
- Health Policy Unit, London School of Hygiene and Tropical Medicine, London.
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Devries KM, Free CJ, Morison L, Saewyc E. Factors associated with pregnancy and STI among Aboriginal students in British Columbia. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2009; 100:226-30. [PMID: 19507728 PMCID: PMC6974225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Accepted: 01/09/2009] [Indexed: 11/14/2023]
Abstract
BACKGROUND Aboriginal adolescents are more likely to become pregnant and contract an STI than other Canadian adolescents. This study provides some of the first data on factors associated with these outcomes among Aboriginal adolescents. METHODS A secondary analysis was conducted using 2003 data from a large cross-sectional survey of British Columbia secondary school students. 445 young women and 360 young men who identified as Aboriginal and reported ever having sex were included in analyses. Associations between self-reported pregnancy and STI and 11 exposure variables were examined using logistic regression. RESULTS Of young women, 10.6% reported a pregnancy; 10.5% of young men reported causing a pregnancy. An STI diagnosis was reported by 4.2% of young women and 3.9% of young men. In multivariate analyses for young men, ever having been sexually abused was the strongest consistent risk factor for causing a pregnancy (AOR = 4.30, 95% CI 1.64-11.25) and STI diagnosis (AOR = 5.58, 95% CI 1.61-19.37). For young women, abuse was associated with increased odds of pregnancy (AOR = 10.37, 95% CI 4.04-26.60) but not STI. Among young women, substance use was the strongest consistent risk factor for both pregnancy (AOR = 3.36, 95% CI 1.25-9.08) and STI (AOR = 5.27, 95% CI 1.50-18.42); for young men, substance use was associated with higher odds of STI (AOR = 4.60, 95% CI 1.11-19.14). Factors associated with decreased risk included community, school and family involvement. CONCLUSIONS Health care professionals, communities and policy-makers must urgently address sexual abuse and substance use. Exploring promotion of school and community involvement and family cohesion may be useful for sexual health interventions with Aboriginal students.
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Affiliation(s)
- Karen M Devries
- Gender Violence and Health Centre, LSHTM, London International Development Centre, 36 Gordon Square, London WC1H OPD.
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