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, Kanbari, Amanda and Kyambadde, Peter, (2023). Examining Pathways from Food Insecurity to Safer Sex Efficacy Among Northern and Indigenous Adolescents in the Northwest Territories, Canada. International Journal of Behavioral Medicine, 31 582-594
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Article
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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
Kyambadde, PeterTitle 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 Publication Date 2023-07-06 Place of Publication N/A Publisher Springer Nature 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
ArcticCopyright Holder Springer Nature Copyright Year 2023 Copyright type All rights reserved DOI 10.1007/s12529-023-10195-w -
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