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.
- ethnic minority and cultural issues
- health education
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Contributors CHL conceptualised the paper and led the writing. CLL conceptualised the FOXY/SMASH programme with MacNeill, led research implementation and contributed to manuscript writing and interpretation. CHL and CLL are co-principal investigators of this study and NM a co-investigator. JF contributed substantially to manuscript writing. NM and KM led data collection and contributed to interpretation. AY led data analysis and contributed to manuscript writing.
Funding The study was supported by funding from the Canadian Institutes of Health Research (CIHR) and the Social Sciences & Humanities Research Council of Canada (SSHRC). Funders played no role in study design or interpretation of findings. CHL was also supported by funding from the Ontario Ministry of Research & Innovation Early Researcher Award, Canada Research Chairs Program and the Canada Foundation for Innovation.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The data are not available to be shared without obtaining ethical approval for changes in the data sharing process.
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