Abstract
Objectives
Sexual partnership patterns, forced sex, and condom non-use can contribute to STI risk, but little is known about these patterns among Aboriginal young people despite elevated STI risk in this group. We describe sexual relationship and condom use patterns among Canadian Aboriginal young people, and how these patterns relate to the socio-structural context as experienced by young people.
Methods
We use data from in-depth individual interviews conducted in 2004 with 22 young people who reported ever having sex and who selfidentified as Aboriginal in British Columbia, Canada. A thematic analysis is presented.
Results
Young people described a range of partnership patterns, including ‘on-off’ relationships which could have high rates of partner turnover but could sometimes be viewed as acceptable contexts for pregnancy, precluding condom use. Contextual elements beyond individual control appeared to contribute to these patterns. Migration between geographic locations was linked with risky partnership patterns, especially if it was linked with family instability or substance use problems.
Conclusion
Sexual health interventions for this group must address partnership patterns in addition to promoting condom use. Survey research into ‘migration’ as a risk factor for STI transmission should consider reasons for migration. Interventions that address both individual level behaviour and the contextual elements that shape behaviour should be developed and tested.
Key words: Aboriginal, condom, STI, HIV, sexual partnership
Résumé
Objectifs
Les structures des partenariats sexuels, les relations sexuelles forcées et la non-utilisation du condom peuvent contribuer aux risques d’ITS, mais on en sait peu sur ces caractéristiques chez les jeunes autochtones malgré le risque élevé d’ITS dans ce groupe. Nous décrivons les caractéristiques des partenariats sexuels et du port du condom chez les jeunes Autochtones canadiens, et leurs liens avec le contexte socioculturel tel qu’il est vécu par ces jeunes.
Méthode
Nos données proviennent d’entretiens individuels approfondis menés en 2004 auprès de 22 jeunes de la Colombie- Britannique, au Canada, ayant déclaré avoir eu des relations sexuelles et s’identifiant comme des Autochtones. Nous en présentons une analyse thématique.
Résultats
Les jeunes ont fait état de toutes sortes de partenariats, y compris des relations « entrecoupées » pendant lesquelles ils peuvent souvent changer de partenaires, mais qu’ils considèrent parfois comme suffisamment stables pour supporter une grossesse et pour exclure le port du condom. Des éléments contextuels indépendants de la volonté des sujets semblent contribuer à ce genre de relations. Les migrations d’un lieu géographique à l’autre étaient liées à des structures de partenariats à risque, surtout en présence d’instabilité familiale ou de problèmes d’alcool ou de toxicomanie.
Conclusion
En plus de promouvoir le port du condom, les interventions en santé sexuelle axées sur ce groupe devraient aborder les structures de partenariat. Les recherches par sondages sur les « migrations » en tant que facteurs de risque de transmission des ITS devraient examiner les raisons de ces migrations. Il faudrait élaborer et tester des interventions qui portent à la fois sur les comportements individuels et sur les éléments contextuels qui les façonnent.
Mots clés: population d’origine amérindienne, condom, maladies sexuellement transmissibles, VIH, partenaire sexuel
Footnotes
Conflict of Interest: None to declare.
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