Citation

Logie CH, Lys CL, Mackay K, MacNeill N, Pauchulo A, Yasseen AS. Int. J. Behav. Med. 2019; 26(4): 449-453.

Affiliation

Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

Copyright

(Copyright © 2019, International Society of Behavioral Medicine, Publisher Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s12529-019-09797-0

PMID

31218560

Abstract

BACKGROUND: Syndemic approaches explore the synergistic relationships between social and health inequities. Such approaches are particularly salient for the Northwest Territories, Canada, that experiences national social (food insecurity, intimate partner violence [IPV]) and health (sexually transmitted infections [STI]) disparities. Safer sex efficacy (SSE) includes knowledge, intention, and relationship dynamics that facilitate safer sex negotiation. We examined factors associated with SSE among NWT adolescents.

METHODS: We conducted a cross-sectional survey with a venue-based sample of adolescents aged 13-17 in 17 NWT communities from 2016 to 2017. Summary statistics and statistical comparisons were conducted, followed by crude and adjusted multivariable regression models to assess factors associated with SSE.

RESULTS: Among participants (n = 610; mean age 14.2 years [SD 1.5]; 49.5% cisgender women, 48.9% cisgender men, 1.6% transgender persons; 73.3% Indigenous), one-quarter (n = 144; 23.6%) reported food insecurity and nearly one-fifth (n = 111; 18.2%) IPV. In adjusted analyses, among young women, food insecurity (β - 1.89[CI - 2.98, - 0.80], p = 0.001) and IPV (β - 1.31[CI - 2.53, - 0.09], p = 0.036) were associated with lower SSE, and currently dating was associated with increased SSE (β 1.17[CI 0.15, 2.19], p = 0.024). Among young men, food insecurity (β - 2.27[CI - 3.39, - 1.15], p = 0.014) was associated with reduced SSE. Among sexually active participants (n = 115), increased SSE was associated with consistent condom use among young women (β 1.40[0.19, 2.61], p = 0.024) and men (β 2.14[0.14, 4.14], p = 0.036).

CONCLUSIONS: Food insecurity and IPV were associated with lower SSE-a protective factor associated with consistent condom use-underscoring the need to address poverty and violence to advance adolescent sexual health in the NWT.

Language: en

Keywords

Arctic; HIV and STI prevention; Indigenous; Resilience; Youth