Abstract
Background
Aboriginal adolescents are more likely to become pregnant and contract an STI than other Canadian adolescents. This study provides some of the first data on factors associated with these outcomes among Aboriginal adolescents.
Methods
A secondary analysis was conducted using 2003 data from a large cross-sectional survey of British Columbia secondary school students. 445 young women and 360 young men who identified as Aboriginal and reported ever having sex were included in analyses. Associations between self-reported pregnancy and STI and 11 exposure variables were examined using logistic regression.
Results
Of young women, 10.6% reported a pregnancy; 10.5% of young men reported causing a pregnancy. An STI diagnosis was reported by 4.2% of young women and 3.9% of young men. In multivariate analyses for young men, ever having been sexually abused was the strongest consistent risk factor for causing a pregnancy (AOR=4.30, 95% CI 1.64–11.25) and STI diagnosis (AOR=5.58, 95% CI 1.61–19.37). For young women, abuse was associated with increased odds of pregnancy (AOR=10.37, 95% CI 4.04–26.60) but not STI. Among young women, substance use was the strongest consistent risk factor for both pregnancy (AOR=3.36, 95% CI 1.25–9.08) and STI (AOR=5.27, 95% CI 1.50–18.42); for young men, substance use was associated with higher odds of STI (AOR=4.60, 95% CI 1.11–19.14). Factors associated with decreased risk included community, school and family involvement.
Conclusions
Health care professionals, communities and policy-makers must urgently address sexual abuse and substance use. Exploring promotion of school and community involvement and family cohesion may be useful for sexual health interventions with Aboriginal students.
Résumé
Contexte
Une adolescente autochtone est plus susceptible de devenir enceinte et contracter une ITS que toute autre adolescente canadienne. Cette étude présente les premières données sur les facteurs associés à ces résultats chez les adolescentes autochtones.
Méthodes
Une analyse secondaire a été réalisée à l’aide des données recueillies en 2003 dans le cadre d’une importante enquête ponctuelle effectuée auprès d’étudiants de niveau secondaire de la Colombie-Britannique. La population de l’analyse comprenait 445 jeunes femmes et 360 jeunes hommes s’identifiant comme des Autochtones et déclarant qu’ils avaient eu des relations sexuelles. Les associations entre la grossesse autodéclarée et l’ITS et 11 variables d’exposition ont été examinées à l’aide d’une analyse de régression logistique.
Résultats
10,6 % des jeunes femmes ont déclaré une grossesse; 10,5 % des jeunes hommes ont indiqué qu’ils avaient causé une grossesse. Un diagnostic d’ITS a été signalé par 4,2 % des jeunes femmes et par 3,9 % des jeunes hommes. Pour ce qui est des analyses multidimensionnelles sur les jeunes hommes, le fait d’avoir été victime de violence sexuelle constitue le plus important facteur de risque conséquent d’avoir causé une grossesse (AOR=4,30; IC95 %: 1,64–11,25) et du diagnostic d’ITS (AOR=5,58; IC95 %: 1,61–19,37). Chez les jeunes femmes, la violence sexuelle a été associée aux probabilités accrues de grossesse (AOR=10,37; IC95 %: 4,04–26,60), mais non au diagnostic d’ITS. Chez les jeunes femmes, la consommation d’alcool et d’autres drogues a été associée aux probabilités accrues de grossesse (AOR=3,36; IC95 %: 1,25–9,08) et de contracter une ITS (AOR=5,27; IC95 %: 1,50–18,42); chez les jeunes hommes, la consommation d’alcool et d’autres drogues a été associée aux probabilités accrues de contracter une ITS (AOR=4,60; IC95 %: 1,11–19,14). Les facteurs suivants ont été associés à une diminution du risque: participation aux activités communautaires, scolaires et familiales.
Conclusions
Les professionnels de la santé, les collectivités et les décideurs doivent urgemment traiter du problème de violence sexuelle et de consommation d’alcool et d’autres drogues. L’exploration des possibilités de favoriser la participation aux activités scolaires et communautaires et la cohésion familiale pourraient contribuer aux efforts d’intervention sur la santé sexuelle des étudiants autochtones.
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Devries, K.M., Free, C.J., Morison, L. et al. Factors Associated with Pregnancy and STI among Aboriginal Students in British Columbia. Can J Public Health 100, 226–230 (2009). https://doi.org/10.1007/BF03405546
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DOI: https://doi.org/10.1007/BF03405546
Key words
- North American Indians
- child sexual abuse
- sexually transmitted diseases
- adolescent pregnancy
- substance abuse