Factors associated with the sexual behavior of Canadian Aboriginal young people and their implications for health promotion.

OBJECTIVES: We examined factors associated with having ever had sex, having more than 1 lifetime sexual partner, and condom nonuse at last incident of sexual intercourse among Canadian Aboriginal young people. METHODS: We conducted a secondary analysis of data from the 2003 British Columbia Adolescent Health Survey, a cross-sectional survey of young people in grades 7 through 12. RESULTS: Of 1140 young Aboriginal men, 34% had ever had sex; of these, 63% had had more than 1 sexual partner, and 21% had not used a condom at their last incident of sexual intercourse. Of 1336 young Aboriginal women, 35% had ever had sex; of these, 56% had had more than 1 sexual partner, and 41% had not used a condom at their last incident of sexual intercourse. Frequent substance use, having been sexually abused, and having lived on a land reservation were strongly associated with sexual behavior outcomes. Feeling connected to family was strongly associated with increased condom use. CONCLUSIONS: Sexual behavior change interventions for Aboriginal young people must move beyond the individual and incorporate interpersonal and structural dimensions. Interventions to reduce substance use and sexual abuse and promote feelings of family connectedness in this population should be explored. Young people living on land reserves need special attention.