Devries Karen M, Free Caroline J, Morison Linda, Saewyc Elizabeth
Gender Violence and Health Centre, LSHTM, London International Development Centre, 36 Gordon Square, London WC1H OPD.
Can J Public Health. 2009 May-Jun;100(3):226-30. doi: 10.1007/BF03405546.
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.
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.
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.
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.
与其他加拿大青少年相比，原住民青少年更有可能怀孕并感染性传播感染（STI）。本研究提供了一些关于原住民青少年中与这些结果相关因素的首批数据。
使用2003年对不列颠哥伦比亚省中学生进行的大型横断面调查数据进行二次分析。分析纳入了445名自我认定为原住民且报告曾有过性行为的年轻女性和360名年轻男性。使用逻辑回归分析自我报告的怀孕和性传播感染与11个暴露变量之间的关联。
年轻女性中，10.6%报告怀孕；年轻男性中，10.5%报告致使他人怀孕。4.2%的年轻女性和3.9%的年轻男性报告有性传播感染诊断。在对年轻男性的多变量分析中，曾遭受性虐待是致使他人怀孕（比值比[AOR]=4.30，95%置信区间[CI]1.64 - 11.25）和性传播感染诊断（AOR = 5.58，95% CI 1.61 - 19.37）最一致的最强风险因素。对于年轻女性，虐待与怀孕几率增加相关（AOR = 10.37，95% CI 4.04 - 26.60），但与性传播感染无关。在年轻女性中，物质使用是怀孕（AOR = 3.36，95% CI 1.25 - 9.08）和性传播感染（AOR = 5.27，95% CI 1.50 - 18.42）最一致的最强风险因素；对于年轻男性，物质使用与性传播感染几率较高相关（AOR = 4.60，95% CI 1.11 - 19.14）。与风险降低相关的因素包括社区、学校和家庭参与。
医疗保健专业人员、社区和政策制定者必须紧急应对性虐待和物质使用问题。探索促进学校和社区参与以及家庭凝聚力可能对针对原住民学生的性健康干预有用。
