Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, UNSW Sydney, Sydney, NSW 2052, Australia; and Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia; and Corresponding author. Email:
School of Public Health, University of Queensland, Brisbane, Qld 4006, Australia; and UQ Poche Centre for Indigenous Health, University of Queensland, Qld 4006, Australia.
Sex Health. 2020 Aug;17(4):303-310. doi: 10.1071/SH19204.
Background Surveillance data indicate that Aboriginal and Torres Strait Islander young people are more likely than their non-Indigenous counterparts to experience sexually transmissible infections (STIs) and teenage pregnancy. Despite increasing emphasis on the need for strengths-based approaches to Aboriginal sexual health, limited published data document how young Aboriginal people reduce sexual health risks encountered in their everyday lives.
In-depth interviews with 35 young Aboriginal women and men aged 16-21 years in two remote Australian settings were conducted; inductive thematic analysis examining sexual health risk reduction practices was also conducted.
Participants reported individual and collective STI and pregnancy risk reduction strategies. Individual practices included accessing and carrying condoms; having a regular casual sexual partner; being in a long-term trusting relationship; using long-acting reversible contraception; having fewer sexual partners; abstaining from sex; accessing STI testing. More collective strategies included: refusing sex without a condom; accompanied health clinic visits with a trusted individual; encouraging friends to use condoms and go for STI testing; providing friends with condoms.
Findings broaden understanding of young Aboriginal people's sexual health risk reduction strategies in remote Aboriginal communities. Findings signal the need for multisectoral STI prevention and sexual health programs driven by young people's existing harm minimisation strategies and cultural models of collective support. Specific strategies to enhance young people's sexual health include: peer condom distribution; accompanied health service visits; peer-led health promotion; continued community-based condom distribution; enhanced access to a fuller range of available contraception in primary care settings; engaging health service-experienced young people as 'youth health workers'.
背景监测数据表明，与非原住民相比，原住民和托雷斯海峡岛民的年轻人更有可能感染性传播感染（STI）和青少年怀孕。尽管越来越强调需要采用基于优势的方法来解决原住民的性健康问题，但很少有已发表的数据记录了年轻的原住民如何在日常生活中减少性健康风险。
在澳大利亚两个偏远地区对 35 名年龄在 16-21 岁的年轻原住民男女进行了深入访谈；还进行了关于减少性健康风险的实践的归纳主题分析。
参与者报告了个人和集体的 STI 和怀孕风险降低策略。个人实践包括获取和携带避孕套；有一个定期的随意性伴侣；建立长期信任关系；使用长效可逆避孕措施；减少性伴侣数量；禁欲；接受性传播感染检测。更多的集体策略包括：拒绝没有避孕套的性行为；在可信赖的人的陪同下前往诊所就诊；鼓励朋友使用避孕套并进行性传播感染检测；为朋友提供避孕套。
研究结果拓宽了对偏远原住民社区中年轻原住民减少性健康风险的策略的理解。研究结果表明，需要多部门共同制定 STI 预防和性健康计划，这些计划要基于年轻人现有的减少伤害策略和集体支持的文化模式。增强年轻人性健康的具体策略包括：同伴 condom 分发；陪同健康服务访问；同伴主导的健康促进；继续在社区内分发 condom；增加在初级保健环境中获得更全面的可用避孕措施的机会；让有经验的青年服务人员参与作为“青年健康工作者”。
