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Research
Sexual practices and condom use among a sample of Northern and Indigenous adolescents in Northern Canada: cross-sectional survey results
  1. Carmen H Logie1,2,
  2. Candice L Lys3,
  3. Jamie Fujioka1,
  4. Nancy MacNeill3,
  5. Kayley Mackay3,
  6. Abdool S Yasseen III4
  1. 1 Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
  2. 2 Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
  3. 3 Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
  4. 4 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Carmen H Logie, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada; carmen.logie{at}utoronto.ca

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.

  • condom
  • teenagers
  • ethnic minority and cultural issues
  • health education
  • surveys

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjsrh-2018-200174

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    Footnotes

    • 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.