Gesink Dionne, Whiskeyjack Lana, Suntjens Terri, Mihic Alanna, McGilvery Priscilla
Dalla Lana School of Public Health, University of Toronto, 155 College St., 6th Floor, Toronto, Ontario M5T 3M7, Canada.
Blue Quills First Nations College, Box 279, St. Paul, Alberta T0A 3A0, Canada.
Child Abuse Negl. 2016 Aug;58:12-23. doi: 10.1016/j.chiabu.2016.06.005. Epub 2016 Jun 20.
STI rates are high for First Nations in Canada and the United States. Our objective was to understand the context, issues, and beliefs around high STI rates from a nêhiyaw (Cree) perspective. Twenty-two in-depth interviews were conducted with 25 community participants between March 1, 2011 and May 15, 2011. Interviews were conducted by community researchers and grounded in the Cree values of relationship, sharing, personal agency and relational accountability. A diverse purposive snowball sample of community members were asked why they thought STI rates were high for the community. The remainder of the interview was unstructured, and supported by the interviewer through probes and sharing in a conversational style. Modified grounded theory was used to analyze the narratives and develop a theory. The main finding from the interviews was that abuse of power in relationships causes physical, mental, emotional and spiritual wounds that disrupt the medicine wheel. Wounded individuals seek medicine to stop suffering and find healing. Many numb suffering by accessing temporary medicines (sex, drugs and alcohol) or permanent medicines (suicide). These medicines increase the risk of STIs. Some seek healing by participating in ceremony and restoring relationships with self, others, Spirit/religion, traditional knowledge and traditional teachings. These medicines decrease the risk of STIs. Younger female participants explained how casual relationships are safer than committed monogamous relationships. Resolving abuse of power in relationships should lead to improvements in STI rates and sexual health.
加拿大和美国的原住民性传播感染率很高。我们的目标是从克里族（Cree）的角度了解性传播感染率高的背景、问题和观念。2011年3月1日至2011年5月15日期间，对25名社区参与者进行了22次深度访谈。访谈由社区研究人员进行，基于克里族关于关系、分享、个人能动性和关系责任的价值观。我们询问了一个多样化的、有目的的滚雪球式社区成员样本，了解他们认为社区性传播感染率高的原因。访谈的其余部分是非结构化的，由访谈者通过提问和以对话方式分享来支持。我们使用修正后的扎根理论来分析这些叙述并形成一种理论。访谈的主要发现是，关系中的权力滥用会造成身体、心理、情感和精神上的创伤，从而扰乱医轮。受伤的人寻求药物来停止痛苦并找到治愈方法。许多人通过使用临时药物（性、毒品和酒精）或永久药物（自杀）来麻木痛苦。这些药物增加了性传播感染的风险。一些人通过参加仪式以及修复与自己、他人、精神/宗教、传统知识和传统教义的关系来寻求治愈。这些药物降低了性传播感染的风险。年轻女性参与者解释了随意关系如何比忠诚的一夫一妻制关系更安全。解决关系中的权力滥用问题应能改善性传播感染率和性健康状况。
