Syndemic Factors Associated with Safer Sex Efficacy Among Northern and Indigenous Adolescents in Arctic Canada.

Autor: Logie CH; Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S 1V4, Canada. carmen.logie@utoronto.ca.; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. carmen.logie@utoronto.ca., Lys CL; Fostering Open eXpression among Youth (FOXY), Yellowknife, Northwest Territories, Canada.; Aurora Research Institute, Inuvik, Northwest Territories, Canada., Mackay K; Fostering Open eXpression among Youth (FOXY), Yellowknife, Northwest Territories, Canada., MacNeill N; Fostering Open eXpression among Youth (FOXY), Yellowknife, Northwest Territories, Canada., Pauchulo A; Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S 1V4, Canada., Yasseen AS 3rd; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: International journal of behavioral medicine [Int J Behav Med] 2019 Aug; Vol. 26 (4), pp. 449-453.
DOI: 10.1007/s12529-019-09797-0
Abstrakt: 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.
Databáze: MEDLINE
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