Poverty, Depression, And Resilience As Joint Predictors Of Condom Use Self-Efficacy Among Northern And Indigenous Youth In Canada

• Main Author: Okumu, Moses
• Format: Other/Unknown Material
• Language: English
• Published: Morressier 2017
• Subjects: Canada; Northwest Territories
• Online Access: https://openresearchlibrary.org/viewer/247f340a-de65-42c2-9f2c-1861fb1ebaa9; https://openresearchlibrary.org/ext/api/media/247f340a-de65-42c2-9f2c-1861fb1ebaa9/assets/external_content.pdf; https://doi.org/10.26226/morressier.5af060641dd164001d5ef399

Background: The Northwest Territories (NWT) has among Canadau2019s highest rates of sexually transmitted infections (STIs) and youth suicide, and nearly one-fifth of persons report low income. There is an urgent need to address the intersections of poverty, mental health, and HIV/STI risk among NWT youth. Fostering Open eXpression among Youth, an Indigenous HIV/STI prevention program, conducts a 10-day peer leader training, incorporating cultural traditions and Elder teachings. The study objective explored associations between social-ecological factors (resilience, food insecurity, depression) and condom self-efficacy among youth peer leaders in the NWT. Methods: We conducted a cross-sectional online survey with youth peer leaders aged 14-17 from 18 NWT communities. We conducted ordinary least squares regression to test the mediating effect of resilience on the relationship between depression and condom use self-efficacy. We then conducted a mediation moderation model to examine if food insecurity changed the strength of the relationship between depression, resilience, and condom self-efficacy. Results: Most peer leaders (n=85; mean age: 15.8 years, SD: 2.1) identified as Indigenous (n=65; 77.4%) and women (n=70; 82.4%); 31% (n=27) identified as lesbian, gay, bisexual, or queer. Most (n=54; 70.1%) reported depressive symptoms, and 42% (n=33) reported food insecurity. Resilience mediated the relationship between depression and condom self-efficacy (b = 0.236, p<0.001, 95% CI = 0.129-0.343). In the mediation moderation model, the indirect effect of depression on condom self-efficacy through resilience was stronger for participants who reported food insecurity (b = 0.245, p<0.050, 95% CI = 0.049-0.440).Discussion: We found that depression was associated with lower resilience, which in turn was associated with reduced condom self-efficacy among NWT youth. We also found an interaction between resilience and food insecurity on condom self-efficacy. Findings have implications for social-ecological interventions to address depression and food insecurity, and foster resilience, to build condom self-efficacy and reduce HIV vulnerabilities.