Abstract
Objectives
To review evidence on factors associated with condom use among Aboriginal people and the methodological quality of studies assessing these factors.
Methods
A systematic review of published and unpublished literature was undertaken. Searches of databases and indexes were performed and authors were contacted directly. Studies reporting on associations between any independent variables and a condom use outcome were included. Data on the quality of each study was extracted, and the strength of evidence for associations between risk factors and condom use outcomes was assessed by counting the number of studies and sample size of each study.
Results
Searches yielded 17 analyses on 10 independent samples that met the inclusion criteria. Most studies were cross-sectional and utilized small non-representative samples. Some evidence for a negative association between condom use and having a steady partner emerged; and a negative association between White male/Alaska Native female sex partner pairs was found. Evidence was insufficient to judge associations between other risk factors and condom use.
Conclusions
The quality and quantity of evidence regarding the predictors of condom use in Aboriginal populations is limited. A concerted effort in primary research on facilitators of and barriers to condom use which are specific to and appropriate for Aboriginal people is needed to inform effective condom promotion interventions for Aboriginal communities.
MeSH terms: Condoms, American Native Continental Ancestry Group, sexually transmitted diseases
Résumé
Objectifs
Examiner les preuves des facteurs associés au port du condom chez les Autochtones et la qualité méthodologique des études qui évaluent ces facteurs.
Méthode
Nous avons mené une étude méthodique des documents publiés et inédits sur la question. Des recherches dans des bases de données et des répertoires ont été effectuées, et les auteurs ont été contactés directement. Nous avons inclus les études portant sur les associations entre toute variable indépendante et ses conséquences sur le port du condom. Nous avons extrait des données sur la qualité de chaque étude, puis évalué la force des preuves d’associations entre les facteurs de risque et leurs conséquences sur le port du condom, en dénombrant les études et en calculant la taille de l’échantillon utilisé dans chaque cas.
Résultats
Nos recherches ont permis de trouver 17 analyses portant sur 10 échantillons indépendants respectant nos critères d’inclusion. Il s’agissait pour la plupart d’études transversales utilisant de petits échantillons non représentatifs. Quelques preuves d’une association négative entre le port du condom et le fait d’avoir une ou un partenaire stable ont été dégagées; et une association négative a été constatée entre les paires de partenaires sexuels composées d’hommes blancs et de femmes autochtones de l’Alaska. Les preuves étaient insuffisantes pour déterminer des associations éventuelles entre d’autres facteurs de risque et le port du condom.
Conclusions
La qualité et la quantité des preuves concernant les prédicteurs du port du condom dans les populations autochtones sont limitées. Si l’on veut améliorer l’efficacité des mesures de promotion du condom dans les communautés autochtones, il faut pousser de façon concertée la recherche primaire sur les éléments propres aux Autochtones, et adaptés à leur situation, qui favorisent ou qui freinent le port du condom.
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