Sexual Health of Canadian Youth: findings from the Canadian Youth, Sexual Health and HIV/AIDS Study.

Abstract: The Canadian Youth, Sexual Health and HIV/AIDS Study conducted in 2002-2003 surveyed a national sample of over 10,000 students in grades 7, 9 and 11. This paper presents the key findings on sexual behaviour including number of steady boyfriend/girlfriend relationships in the past year, sexual behaviours experienced, and for grades 9 and 11 only, experience of oral sex and sexual intercourse, reasons for having or not having had intercourse, experience of non-consensual sexual intercourse, contraception use at last intercourse, condom use and attitudes, experience of unintended pregnancy, and sense of self-efficacy in HIV/AIDS prevention. Compared to the last such national study conducted in 1988, males but not females were less likely to have had intercourse and all students were significantly more likely to believe they could protect themselves from HIV/AIDS.

Key words: Teen sexual behaviour, national Canadian survey, sexual health.

Introduction

Few large-scale studies of adolescent sexual health have been conducted in Canada. In 1988, the Canada Youth and AIDS Study (CYAS) (King, Beazley, Warren et al., 1989) was administered during a time of insecurity and concern over a new epidemic. Since then, some national level evaluations of sexual health education curricula have been undertaken (Council of Ministers of Education, Canada, 1999), and some provinces have revised their health education curricula to include a sexual health component. However, in the past decade there have been no cross-Canada studies focusing explicitly on younger adolescents' sexual health.

Behaviours that promote sexual health can result in the prevention of sexual health problems, e.g., unintended pregnancy, sexually transmitted infections (STI, HIV/AIDS), sexual coercion, and the enhancement of sexual health, e.g., positive self-image, satisfying relationships, and desired parenthood (Health Canada, 2003). According to the Canadian Guidelines for Sexual Health Education, these outcomes are facilitated by educational programs that help young people to acquire knowledge, develop motivation, personal insight, and behavioural skills, and that foster creation of an environment conducive to sexual health (Health Canada, 2003).

From a population health perspective, sociodemographic determinants of sexual health have been linked to sexual behaviours and the sexual health of adolescent populations. Parental income, occupation, educational achievement, degree of religiosity, gender identity and disability have all been found to be related to sexual activity during the teenage years. The school context represents another environmental variable that has been linked to the health of youth (King, Boyce, & King, 1999). Further, adolescents with emotional and mental health difficulties, as indicated by a lack of coping skills, are more likely to engage in risk behaviours related to eating disorders, as well as smoking, alcohol, and drug use. Such risk behaviours are associated with early initiation of sexual experiences (Taylor-Seehafer, & Rew, 2000; Tonkin, Murphy, & Poon, in press).

Family structures and the nature of relationships among family members are also determinants of sexual health (Kotchik, Shaffer, Forehand, & Miller, 2001; Turner, Irwin, Tschann, & Millstein, 1993). Parental communication, role modeling, and trust of adolescents has been related to depression and risky sexual behaviour among teens (Feldman & Brown, 1993). Adolescent interactions within peer groups, and their perceptions of these interactions, constitute another important factor. Peer groups offer adolescents access to health information, as well as collective frameworks for interpreting this information. Further, the extent to which an adolescent is integrated into a peer group is related to whether he or she will manifest physical or emotional problems (Page, Scanlan, & Deringer, 1994). Finally, the presence of health and social organizations in a community, and adolescent awareness of information associated with these services, has been associated with adolescent sexual health behaviours. Indeed, some limited evidence indicates that access to community health services and sexual education reduces adolescent pregnancy rates (Orton & Rosenblatt, 1991).