BackgroundThere is a dearth of literature to guide the development of community-based HIV and sexually transmitted infection (STI) prevention and sexual health promotion programs within Inuit communities.ObjectiveThe aim of this study was to create a dialogue with Inuit women to address the lack of information available to inform programming to improve the sexual health of Inuit women, their families, and their communities in the Canadian Arctic.DesignThis study used Indigenous methodologies and methods by drawing from Inuit Qaujimajatuqangit and postcolonial research theory in a framework of Two-Eyed Seeing, and using storytelling sessions to gather data. Community-based participatory research principles informed the design of the study, ensuring participants were involved in all stages of the project. Nine storytelling sessions took place with 21 Inuit women aged 18–61 years. Storytelling sessions were audio recorded and transcribed verbatim, and Atlas.ti aided in the organization of the data for collaborative thematic analysis within three participatory analysis sessions with 13 of the participating women.ResultsFrom the storytelling and analysis sessions, five major themes emerged: (a) the way it used to be, (b) change, (c) family, (d) intimate relationships and (e) holistic strategies. Participating women emphasized that HIV and STI prevention and sexual health promotion programming needs to take a holistic, community-wide, family-focused and youth-centred approach within their communities.ConclusionParticipants identified several important determinants of sexual health and shared ideas for innovative approaches they believe will work as prevention efforts within their communities. This article specifically focuses on key characteristics of programming aimed at STI and HIV prevention and sexual health promotion that were identified throughout participants’ stories. This study has provided a narrative to complement the epidemiological data that highlight the urgent need for prevention programming.
Background Indigenous Peoples are impacted by industrial resource development that takes place on, or near, their communities. Existing literature on impacts of industrial resource development on Indigenous Peoples primarily focus on physical health outcomes and rarely focus on the mental health impacts. To understand the full range of long-term and anticipated health impacts of industrial resource development on Indigenous communities, mental health impacts must be examined. It is well-established that there is a connection between the environment and Indigenous wellbeing, across interrelated dimensions of mental, physical, emotional, and spiritual health. Methods This paper identifies how the Community Advisory Team and a team of Indigenous and settler scholars will conduct the review. The literature search will use the OVID interface to search Medline, Embase, PsycINFO, and Global Health databases. Non-indexed peer-reviewed journals related to Indigenous health or research will be scanned. Books and book chapters will be identified in the Scopus and PsycINFO databases. The grey literature search will also include Google and be limited to reports published by government, academic, and non-profit organizations. Reference lists of key publications will be checked for additional relevant publications, including theses, dissertations, reports, and other articles not retrieved in the online searches. Additional sources may be recommended by team members. Included documents will focus on Indigenous Peoples in North America, South America, Australia, Aotearoa New Zealand, and Circumpolar regions, research that reports on mental health, and research that is based on land loss connected to dams, mines, agriculture, or petroleum development. Literature that meets the inclusion criteria will be screened at the title/abstract and full-text stages by two team members in Covidence. The included literature will be rated with a quality appraisal tool and information will be extracted by two team members; a consensus of information will be reached and be submitted for analysis. Discussion The synthesized evidence from this review is relevant for land use policy, health impact assessments, economic development, mental health service planning, and communities engaging in development projects. Systematic review registration Registered in the International Prospective Register of Systematic Reviews (PROSPERO; Registration number CRD42021253720)
Background Early sexual initiation is a risk factor for sexually transmitted infection and unintended pregnancy. Native American youth initiate sex earlier than other U.S. youth contributing to current inequalities in sexual health. Identifying factors that predict lifetime sexual experience among Native youth can inform the development of primary prevention programming to delay sexual initiation and improve sexual health outcomes in this population. Methods We analyzed cross-sectional data from 558 Native youth ages 11-19 from a rural, reservation-based community. Multivariate logistic regression models were used to estimate associations between lifetime sexual experience (vaginal and/or anal sex) and independent variables across eight categories: sociodemographic, knowledge, attitudes/perceptions, beliefs, intentions, skills, behaviors, and theoretical constructs. Results The sample was 51.6% female, mean age 13.4 years (SD=1.9); and 8.0% were sexually experienced. In our final model, older age (OR=2.04; p<0.0001) and identifying as transgender (OR=35.3; p=0.019) predicted lifetime sexual experience. The notion that sometimes sex just happens (OR=0.56; p=0.01), and having condom use self-efficacy (OR=0.47, p=0.026) were negatively associated with lifetime sexual experience. Youth who intended to have sex in the next 6 months were more likely to be sexually experienced (OR=3.18; p<0.0001). Recent substance use including having smoked cigarettes (OR=4.38, p=0.048), and having smoked marijuana in the past 3 months (OR=6.48, p=0.002) predicted lifetime sexual experience. Conclusion Results provide direction for future programming. Programs focusing on intentions to have sex while cultivating skills to promote condom use, in addition to being delivered stratified by age, may have the greatest impact. Substance use was a driving factor in sexual initiation; thus, sexual health education programs should simultaneously target substance use prevention. That identifying as transgendered predicted sexual experience is notable: despite research indicating transgendered youth of other ethnicities have heightened risk for negative sexual health outcomes, little research has been conducted with transgendered Native youth. Disclosure No significant relationships.
Background Indigenous Peoples are impacted by industrial development projects that take place on, or near, their communities. Existing literature on impacts of industrial projects on Indigenous Peoples primarily focus on physical health outcomes and rarely focus on the mental health impacts. To understand the full range of long-term and anticipated health impacts of industrial resource development on Indigenous communities, mental health impacts must be examined. It is well-established that there is a connection between the environment and Indigenous wellbeing, across interrelated dimensions of mental, physical, emotional, and spiritual health. This systematic review will synthesize the evidence on the mental health impacts of land dispossession due to resource extractive projects on Indigenous communities. Looking at the mental health impacts of land dispossession from industrial resource development on Indigenous communities is relevant for a variety of reasons including planning, mitigation strategies, decision making, and negotiations. Methods This review includes an Indigenous Advisory Team and a team of Indigenous and settler scholars. The literature search will use the OVID interface to search Medline, Embase, PsycINFO, and Global Health databases. Non-indexed peer reviewed journals related to Indigenous health or research will be scanned. Books and book chapters will be identified in the Scopus and PsycINFO databases. The grey literature search will also include Google and be limited to reports published by government, academic, and non-profit organizations. Reference lists of key publications will be checked for additional relevant publications, including theses, dissertations, reports, and other articles not retrieved in the online searches. Additional sources may be recommended by team members. Included documents will focus on Indigenous Peoples in North America, South America, Australia, Aotearoa New Zealand, and Circumpolar regions, research that reports on mental health, and research that is based on land loss connected to dams, mines, agriculture, oil and gas. Literature that meets the inclusion criteria will be screened at the title/abstract and full text stages by two team members in Covidence. The included literature will be rated with a quality appraisal tool and information will be extracted by two team members; a consensus of information will be reached and be submitted for analysis. Discussion The evidence from this review is relevant for land use policy, health impact assessments, economic development, mental health service planning, and communities engaging in development projects. Systematic review registration: Registered in the International Prospective Register of Systematic Reviews (PROSPERO; Registration number CRD42021253720)
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