TY - JOUR
T1 - Pathways between depression, substance use and multiple sex partners among Northern and Indigenous young women in the Northwest Territories, Canada
T2 - Results from a cross-sectional survey
AU - Logie, Carmen H.
AU - Lys, Candice
AU - Okumu, Moses
AU - Leone, Cristina
N1 - Funding Information:
Funding this study was supported by the Canadian Institutes of health research, Institute of Aboriginal peoples’ health. ChL is also supported by an ontario Ministry of research and Innovation early researcher Award. Funders played no role in study design, interpretation, analysis or manuscript preparation.
Funding Information:
This study was supported by the Canadian Institutes of Health Research, Institute of Aboriginal Peoples' Health. CHL is also supported by an Ontario Ministry of Research and Innovation Early Researcher Award. Funders played no role in study design, interpretation, analysis or manuscript preparation.
Publisher Copyright:
© 2018 Article author(s). All rights reserved.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Objectives: Sexual and mental health disparities exist in the Northwest Territories (NWT) compared with other Canadian regions. STI rates are 10-fold higher, and youth suicide rates double the Canadian average. Scant research has examined associations between mental and sexual health among youth in the NWT. The study objective was to explore pathways from depression to multiple sex partners (MSP) among young women in the NWT, Canada. Methods: We implemented a cross-sectional survey in 2015-2016 with a venue-based recruitment sample of young women aged 13-17 attending secondary schools in 17 NWT communities. We conducted path analysis to test a conceptual model examining associations between depression and a history of MSP, examining substance use and peer support as mediators. Results: Participants (n=199; mean age: 13.8, SD: 1.27) mostly identified were Indigenous (n=154; 77.4%) and one-fifth (n=39; 20.5%) were sexually diverse/non-heterosexual. Almost two-thirds (n=119; 63.3%) reported depression symptoms. One-quarter (n=53; 26.6%) were currently dating, and 16.1% (n=32) reported a lifetime history of >1 sex partner (classified as having MSP). There was no direct effect between depression and MSP (β=0.189, p=0.087, 95% CI 0.046 to 0.260). Depression had a direct effect on substance use (β=0.023, p<0.050, 95% CI 0.118 to 0.500), and an indirect effect on MSP through substance use (β=0.498, SE=0.10, p<0.001, 95% CI 0.141 to 0.280). Depression was associated with lower peer support (β=-0.168, p<0.010, 95% CI -0.126 to 0.280); peer support was not associated with MSP (β=-0.158, p=0.130, 95% CI -0.126 to 0.001). Conclusion: This research is among the first to identify mental health factors associated with STI vulnerability among young women in the NWT. Findings demonstrate the importance of addressing depression and substance use in sexual health interventions in Northern contexts.
AB - Objectives: Sexual and mental health disparities exist in the Northwest Territories (NWT) compared with other Canadian regions. STI rates are 10-fold higher, and youth suicide rates double the Canadian average. Scant research has examined associations between mental and sexual health among youth in the NWT. The study objective was to explore pathways from depression to multiple sex partners (MSP) among young women in the NWT, Canada. Methods: We implemented a cross-sectional survey in 2015-2016 with a venue-based recruitment sample of young women aged 13-17 attending secondary schools in 17 NWT communities. We conducted path analysis to test a conceptual model examining associations between depression and a history of MSP, examining substance use and peer support as mediators. Results: Participants (n=199; mean age: 13.8, SD: 1.27) mostly identified were Indigenous (n=154; 77.4%) and one-fifth (n=39; 20.5%) were sexually diverse/non-heterosexual. Almost two-thirds (n=119; 63.3%) reported depression symptoms. One-quarter (n=53; 26.6%) were currently dating, and 16.1% (n=32) reported a lifetime history of >1 sex partner (classified as having MSP). There was no direct effect between depression and MSP (β=0.189, p=0.087, 95% CI 0.046 to 0.260). Depression had a direct effect on substance use (β=0.023, p<0.050, 95% CI 0.118 to 0.500), and an indirect effect on MSP through substance use (β=0.498, SE=0.10, p<0.001, 95% CI 0.141 to 0.280). Depression was associated with lower peer support (β=-0.168, p<0.010, 95% CI -0.126 to 0.280); peer support was not associated with MSP (β=-0.158, p=0.130, 95% CI -0.126 to 0.001). Conclusion: This research is among the first to identify mental health factors associated with STI vulnerability among young women in the NWT. Findings demonstrate the importance of addressing depression and substance use in sexual health interventions in Northern contexts.
KW - adolescent
KW - American native continental ancestry group
KW - depression
KW - sexually transmitted diseases
KW - substance-related disorders
KW - women
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U2 - 10.1136/sextrans-2017-053265
DO - 10.1136/sextrans-2017-053265
M3 - Review article
C2 - 28988191
AN - SCOPUS:85047168459
VL - 94
SP - 604
EP - 606
JO - Sexually Transmitted Infections
JF - Sexually Transmitted Infections
SN - 1368-4973
IS - 8
ER -