| Summary: | Background: Very little data exists on the overrepresentation of Aboriginal people among HIV and sexually transmitted infection cases in Canada, and how these vulnerabilities interplay with historic trauma, sexual abuse and the utilization of condoms as a protective barrier.
Purpose: This analysis explores potential risk factors for inconsistent condom use among the young Aboriginal men and women participating in the Cedar Project at baseline and over time.
Methods: The Cedar Project is an ongoing prospective study of Aboriginal young people in Vancouver and Prince George who use injection and non-injection drugs. This analysis includes data from October, 2003 and April 2005. Venous blood samples tested for HIV and HCV antibodies. Multivariable modeling identified risk factors associated with inconsistent condom use in this cohort at baseline. Due to the serial measurements for each study subject, generalized estimating equations (GEE) modeling with logit link was used to accommodate the temporal correlation within the subjects.
Results: Of the 292 women and 313 men examined at baseline, prevalence of inconsistent condom use during insertive sex was 59% and 46%, respectively. In multivariable regression, inconsistent condom use among women was significantly associated with ever being enrolled in a drug/alcohol treatment program, and ever being sexually abused. Among men, inconsistent condom use was significantly associated with having more than 20 lifetime sex partners. Inconsistent condom use was associated with not being single for the entire cohort.
For young women, the predictive risk factors for inconsistent condom use over time included experiencing sexual abuse within the last 6 months. All the young men and women of the Cedar Project who used condoms inconsistently were more likely to not be single, live in Prince George, smoke crack on a daily basis, and have ever had a sexually transmitted infection. Among the participants who used injection drugs, sexual vulnerability was associated with sharing rigs.
Conclusions: Sexual health programs for Aboriginal young people, especially those who are vulnerable to drug use, must be made a priority. These interventions must incorporate the reality of gendered differences in the context of multigenerational trauma, including nonconsensual sex.
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