Young Aboriginal people’s sexual health risk reduction strategies: a qualitative study in remote Australia
Stephen Bell A B M , James Ward C D , Peter Aggleton B E , Walbira Murray F , Bronwyn Silver F , Andrew Lockyer F , Tellisa Ferguson F , Christopher K. Fairley G H , David Whiley I , Nathan Ryder A J K , Basil Donovan A , Rebecca Guy A , John Kaldor A and Lisa Maher A LA Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, UNSW Sydney, Sydney, NSW 2052, Australia.
B Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia.
C School of Public Health, University of Queensland, Brisbane, Qld 4006, Australia.
D UQ Poche Centre for Indigenous Health, University of Queensland, Qld 4006, Australia.
E College of Arts and Social Sciences, The Australian National University, Canberra, ACT 2600, Australia.
F Central Australian Aboriginal Congress Aboriginal Corporation, Alice Springs, NT 0871, Australia.
G Melbourne Sexual Health Centre, Carlton, Vic. 3053, Australia.
H Central Clinical School, Monash University, Melbourne, Vic. 3004, Australia.
I University of Queensland, Brisbane, Qld 4006, Australia.
J Pacific Clinic Newcastle, HNE Sexual Health, Newcastle, NSW 2302, Australia.
K School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia.
L Burnet Institute, Melbourne, Vic. 3004, Australia.
M Corresponding author. Email: sbell@kirby.unsw.edu.au
Sexual Health 17(4) 303-310 https://doi.org/10.1071/SH19204
Submitted: 18 November 2019 Accepted: 17 February 2020 Published: 3 August 2020
Journal Compilation © CSIRO 2020 Open Access CC BY-NC-ND
Abstract
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. Methods: 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. Results: 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. Conclusion: 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’.
Additional keywords: Indigenous, pregnancy, STIs, strengths-based, youth.
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