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The Cedar Project: Sexual Vulnerabilities Among Aboriginal Young People Involved in Illegal Drug Use in Two Canadian Cities

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Abstract

Objectives: Very few studies in Canada address the sexual health of young Aboriginal people who use drugs; the focus in established literature has been on parenteral risks. This study sought to identify the risk factors associated with inconsistent condom use in a cohort of young Aboriginal people who live in British Columbia and use drugs.

Methods: This analysis includes baseline questionnaire data from October 2003 to April 2005. Multivariable modeling stratified by gender identified independent demographic, traumatic, sex and drug use risk factors associated with inconsistent condom use.

Results: Of the 292 women and 313 men at baseline, prevalence of inconsistent condom use during insertive sex was 59% and 46%, respectively. In multivariable logistic regression, after adjusting for age and location, inconsistent condom use among women was significantly associated with ever being enrolled in a drug/alcohol treatment program (AOR: 1.95, 95% CI: 1.06–3.60), and ever being sexually abused (AOR: 1.80, 95% CI: 1.01–3.20). Among men, inconsistent condom use was significantly associated with having more than 20 lifetime sex partners (AOR: 2.06, 95% CI: 1.24–3.44).

Conclusion: Our study demonstrates high rates of inconsistent condom use among young Aboriginal people who use drugs, highlighting their vulnerability to contracting sexually transmitted infections. Culturally tailored sexual health interventions must be made a priority and need to incorporate the reality of gendered differences in the context of multigenerational trauma, including non-consensual sex.

Résumé

Objectifs: Très peu d’études au Canada abordent la santé sexuelle des jeunes autochtones qui consomment de la drogue; les travaux publiés portent plutôt sur les risques de transmission parentérale de maladies. Nous avons voulu cerner les facteurs de risque associés à l’utilisation irrégulière du préservatif dans une cohorte de jeunes autochtones consommateurs de drogue vivant en Colombie-Britannique.

Méthode: Nous avons analysé les données d’un questionnaire de référence administré entre octobre 2003 et avril 2005. Une modélisation multivariée stratifiée selon le sexe a permis de cerner des facteurs de risque indépendants (caractéristiques démographiques, traumatismes, relations sexuelles et consommation de drogue) associés à l’utilisation irrégulière du préservatif.

Résultats: Chez les 292 femmes et les 313 hommes recensés au départ, la prévalence de l’utilisation irrégulière du préservatif durant les relations sexuelles avec pénétration était de 59 % et de 46 %, respectivement. Après une régression logistique multivariée, en tenant compte de l’âge et du lieu, l’utilisation irrégulière du préservatif chez les femmes présentait une corrélation significative avec le fait d’avoir déjà suivi un programme de traitement des toxicomanies ou de l’alcoolisme (RCa: 1,95, IC de 95 %: 1,06–3,60), et d’avoir déjà été victime d’agression sexuelle (RCa: 1,80, IC de 95 %: 1,01–3,20). Chez les hommes, l’utilisation irrégulière du préservatif présentait une corrélation significative avec le fait d’avoir eu plus de 20 partenaires sexuels dans sa vie (RCa: 2,06, IC de 95 %: 1,24–3,44).

Conclusion: Notre étude fait état de taux élevés d’utilisation irrégulière du préservatif chez les jeunes autochtones qui consomment de la drogue, d’où leur vulnérabilité aux infections transmissibles sexuellement. Des interventions en santé sexuelle culturellement adaptées doivent être menées en priorité, et elles doivent tenir compte de la réalité des différences sexospécifiques dans le contexte des traumatismes multigénérationnels, y compris les rapports sexuels non consensuels.

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Authors and Affiliations

  1. School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada

    Negar Chavoshi MSc, Negar Chavoshi MSc, Akm Moniruzzaman PhD, Chris G. Richardson PhD, Martin T. Schechter MD & Patricia M. Spittal PhD

  2. First Nations and Inuit Health Branch of British Columbia, Vancouver, BC, Canada

    Shannon Waters MD

Authors
  1. Negar Chavoshi MSc
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  2. Shannon Waters MD
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  3. Akm Moniruzzaman PhD
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  4. Chris G. Richardson PhD
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  5. Martin T. Schechter MD
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  6. Patricia M. Spittal PhD
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Corresponding author

Correspondence to Negar Chavoshi MSc.

Additional information

Supported by funding from: Canadian Institutes of Health Research and Kloshe Tillicum Network Environments for Aboriginal Health Research.

Conflict of Interest: None to declare.

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Chavoshi, N., Waters, S., Moniruzzaman, A. et al. The Cedar Project: Sexual Vulnerabilities Among Aboriginal Young People Involved in Illegal Drug Use in Two Canadian Cities. Can J Public Health 103, e413–e416 (2012). https://doi.org/10.1007/BF03405628

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  • DOI: https://doi.org/10.1007/BF03405628

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