Examining Pathways from Food Insecurity to Safer Sex Efficacy Among Northern and Indigenous Adolescents in the Northwest Territories, Canada

Background Food insecurity is a social determinant of health linked with elevated HIV exposure. Safer sex efficacy (SSE), the ability to navigate sexual decision-making and condom use, is an important marker of sexual wellbeing. Pathways from food insecurity to SSE are understudied, particularly amo...

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Vydané v:International Journal of Behavioral Medicine Ročník 31; číslo 4; s. 582 - 594
Hlavní autori: Logie, Carmen H., Lys, Candice, Sokolovic, Nina, Malama, Kalonde, Mackay, Kayley Inuksuk, McNamee, Clara, Lad, Anoushka, Kanbari, Amanda
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: New York Springer Science and Business Media LLC 01.08.2024
Springer US
Springer Nature B.V
Predmet:
Adolescent
Adolescents
Condoms
Condoms - statistics & numerical data
Cross-Sectional Studies
Decision making
Depression - epidemiology
Depression - psychology
Family Medicine
Female
Food Insecurity
Food security
Full Length Manuscript
General Practice
Health Psychology
Humans
Male
Medicine
Medicine & Public Health
Mental depression
Northwest Territories
Resilience (Psychology)
Resilience, Psychological
Safe Sex - psychology
Safe Sex - statistics & numerical data
Sexual behavior
Sexual health
Social determinants of health
Teenagers
Northwest Territories
Canada
Northwest Territories Canada
Food insecurity
Safe sex efficacy
Adolescents
Arctic
Resilience
ISSN:1070-5503, 1532-7558, 1532-7558
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Shrnutí:Background Food insecurity is a social determinant of health linked with elevated HIV exposure. Safer sex efficacy (SSE), the ability to navigate sexual decision-making and condom use, is an important marker of sexual wellbeing. Pathways from food insecurity to SSE are understudied, particularly among adolescents in Arctic regions who are at the nexus of food insecurity and sexual health disparities. We examined pathways from food insecurity to SSE among adolescents in the Northwest Territories (NWT), Canada. Methods We implemented cross-sectional surveys with adolescents aged 13–18 recruited through venue-based sampling in 17 NWT communities. We conducted multivariable logistic regression to assess socio-demographic factors associated with food insecurity. We then conducted structural equation modeling (SEM) using maximum likelihood estimation to assess direct effects of food insecurity on SSE and indirect effects via resilience, depression, and relationship power inequity. We assessed both condom use SSE (e.g., confidence in using condoms) and situational SSE (e.g., SSE under partner pressure). Results Most participants ( n  = 410) identified as Indigenous (79%) and 45% reported experiencing food insecurity. In SEM, we did not find a significant direct effect from food insecurity to SSE; however, we found indirect effects from food insecurity to condom use SSE through resilience and depression and from food insecurity to situational SSE through resilience. Conclusions Findings call for structural interventions to address food insecurity, alongside resilience-focused strategies that address the intersection of sexual and mental health. Sexual health strategies focused on individual behavior change are insufficient to address larger contexts of poverty among Northern youth.
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ISSN:1070-5503
1532-7558
1532-7558
DOI:10.1007/s12529-023-10195-w