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Title: Condom use and sexual health among Canadian Aboriginal Youth
Author: Devries, Karen Maria
ISNI:       0000 0004 2744 9211
Awarding Body: University of London
Current Institution: London School of Hygiene and Tropical Medicine (University of London)
Date of Award: 2007
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Background Aboriginal youth are more likely to contract a variety of STIs versus other Canadian youth, but the determinants of sexual health in this group are seldom researched. This thesis explores condom use and sexual health among Aboriginal youth and generates recommendations for interventions. Methods Two systematic reviews were conducted examining relationships between different factors and condom use, among indigenous peoples and other diverse groups of youth. Next, qualitative interviews were conducted with 30 Aboriginal youth in British Columbia, Canada. Finally, a secondary analysis of cross-sectional data from a large, representative survey was performed to model relationships between various exposures and ever having sex, having more than one sexual partner, condom use, STI diagnosis and pregnancy involvement. Results The two systematic reviews revealed serious potential bias in studies assessing condom use among indigenous peoples and other diverse groups. Few factors were tested across populations, and little insight was gained as to which factors may differ in their relative importance. In the qualitative study, youth with less stable family relationships and negative life experiences described more risky sexual behaviour than those who did not. Both genders engaged in coercive sexual negotiation, and sometimes young women insisted on condom non-use. Youth also described concurrent/serially monogamous relationships with rapid rates of partner change. These relationships could be 'serious', and 'serious' relationships could denote an acceptable context for pregnancy. In the cross-sectional study, substance use, unwanted sex, and living on reserve increased risk of multiple outcomes. Feeling more connected to family was strongly protective for both genders, and for girls, helping out in the community was also protective. Conclusions Interventions addressing substance use, sexual communication and family relationships may be efficacious for improving sexual health among Aboriginal youth. Building on youth's own ideas about positive lifestyles could be an effective method of tailoring.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available