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

Logie, Carmen H, Lys, Candice, Sokolovic, Nina, Malama, Kalonde, Inuksuk Mackay, Kayley, McNamee, Clara, Lad, Anoushka and Kanbari, Amanda, (2024). Examining Pathways from Food Insecurity to Safer Sex Efficacy Among Northern and Indigenous Adolescents in the Northwest Territories, Canada. International Journal of Behavioral Medicine, 31(4), 582-594

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  • Sub-type Journal article
    Author Logie, Carmen H
    Lys, Candice
    Sokolovic, Nina
    Malama, Kalonde
    Inuksuk Mackay, Kayley
    McNamee, Clara
    Lad, Anoushka
    Kanbari, Amanda
    Title Examining Pathways from Food Insecurity to Safer Sex Efficacy Among Northern and Indigenous Adolescents in the Northwest Territories, Canada
    Appearing in International Journal of Behavioral Medicine
    Volume 31
    Issue No. 4
    Publication Date 2024-08-01
    Place of Publication New York
    Publisher Springer US
    Start page 582
    End page 594
    Language eng
    Abstract 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.
    Keyword Food insecurity
    Safe sex efficacy
    Resilience
    Adolescents
    Arctic
    Copyright Holder Springer Nature
    Copyright Year 2024
    Copyright type All rights reserved
    DOI https://doi.org/10.1007/s12529-023-10195-w
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    Created: Wed, 23 Oct 2024, 00:43:45 JST by Haideh Beigi on behalf of UNU INWEH