Canadian aboriginal youth: social, interpersonal factors are key to sexual behavior.

A variety of characteristics--mainly related to the social environment and interpersonal experiences--are associated with the sexual behavior of Canadian Aboriginal adolescents, according to an analysis of data from a cross-sectional survey (1) One-third of both male and female adolescents surveyed had ever had sex. Among those with sexual experience, three in five of each gender had had more than one partner; 21% of men and 41% of women had not used a condom at last intercourse. Youth who reported frequent use of alcohol or drugs, had been sexually abused or had ever lived on a land reserve had elevated odds of some or all of these sexual behaviors. On the other hand, the more connected youth felt to their family or their school, the lower their odds.

Investigators conducted a secondary analysis of data from the 2003 British Columbia Adolescent Health Survey, which is administered every 5-6 years to students enrolled in grades 7-12 in randomly sampled classrooms in the province. The analysis was restricted to participants who identified themselves as Aboriginal. The investigators ascertained the prevalence and predictors of three sexual behaviors: having ever had sex, having had more than one sexual partner and having not used a condom at last intercourse. The potential predictors studied consisted of social environmental characteristics, interpersonal characteristics, individual-level characteristics and situational characteristics at the time of sexual encounters.

Analyses were based on 1,140 male and 1,336 female Aboriginal youth, who were about 15 years old, on average. Overall, 34% of young men and 35% of young women had ever had sex. Among sexually experienced youth, 63% of males and 56% of females had had more than one sexual partner; 21% and 41%, respectively, had not used a condom at last intercourse.

Large proportions of the adolescents reported having learned about their culture from their family (70-76%), school (68-78%) and community (49-55%). Sizable minorities of both males and females had ever lived on a reserve (29% and 27%, respectively) and had volunteered in their community in the past year (22% and 35%). Fully 75% of young women and 55% of young men said that if they were involved in a pregnancy, their peers would be angry The young people reported fairly high levels of connectedness to their family (mean score, 2.4-2.5 on a scale of 1-3) and to their school (mean score, 3.5 for each gender on a scale of 1-5). One-quarter of both male and female adolescents had a high (above-median) lifetime level of substance use.

Some 40% of sexually experienced young women and 10% of their male counterparts had been sexually abused or forced into sex. Sizable proportions (31% and 14%, respectively) had used a method of contraception other than a condom at last sex. And about a third of women (35%) and men (34%) alike reported substance use at last sex.

In multivariate analyses, males' likelihood of being sexually experienced increased with their age (odds ratio for each additional year of age, 1.5), and was elevated if they had ever lived on a reserve (1.9) or had a high lifetime level of substance use (10.0). Similarly, for females, the odds of being sexually experienced were positively associated with age (1.7), having ever lived on a reserve (1.6) and having a high lifetime level of substance use (4.0); the more connected females felt to their school, the lower their odds (0.7).

Both young men and young women had elevated odds of having had multiple partners if they had a high lifetime level of substance use (odds ratios, 2.2 and 6.1). Women's odds also increased with age (1.2) and were positively associated with having been sexually abused or coerced into sex (2.0) and having learned about the culture from the community (2.1). Women were less likely to have had multiple partners if they had learned about their culture from their school (0.5) or had volunteered in their community in the past year (0.3) than if they had not had these experiences.

Adolescent men and women alike were markedly more likely not to have used

condoms at last intercourse if they had used some other form of contraception (odds ratios, 39.7 and 101.3). In addition, the odds of condom nonuse were elevated among men who had been sexually abused or coerced (4.5), and among women who were older (1.5) or had ever lived on a reserve (7.8). On the other hand, the more connected both males and females felt to their family, the less likely they were to have forgone condom use (0.5 and 0.4). Females were also less likely to have done so if they had learned about their culture from their family (0.4).

The investigators note that several predictors of risky sexual behavior--notably, substance use and sexual abuse--are more prevalent among indigenous youth than among other youth. "Therefore," they write, "it is imperative that these variables are addressed when planning interventions for this group." Moreover, including youth who have lived on reserves will be especially important.

REFERENCE

(1.) Devries KM et al., Factors associated with the sexual behavior of Canadian Aboriginal young people and their implications for health promotion, American Journal of Public Health, 2009, 99(5):855-462.