Preventing sexually transmitted infections

Dr. Susan Frohlick (women’s and gender studies and anthropology) presented her research Nov. 4, 2013, entitled “Give them condoms: Citizenship 101 and the risks of safer sex discourses.” She asked how the way educators talk about safe sex might contribute to the risk of harm instead of reducing that harm for immigrant youth. Youth involved in the study described Canadian safe sex messages as deeply related to citizenship and belonging. African youth as newcomers to Canada are figuring out new meanings and practices of sex and sexuality while simultaneously reconfiguring masculinity and femininity, racial and cultural identities and citizenship. How and why does HIV risk matter to these youth? “The short answer is that it doesn’t matter much, at least not the way one might expect,” Frohlick said.

She said the Canadian idea of safe sex or sex positivity, such as giving out condoms, imposed on newcomers. The participants agreed that the idea of safer sex is very Canadian and is part of what it means to be Canadian. For example, Canadian girls are not ashamed of carrying condoms in their purses. These messages are not necessarily aligning up with their own realities.

African youth were more concerned about their bodies being associated with HIV – because the virus is prevalent in some parts of Africa – than about contracting HIV. When HIV was brought up in focus groups, the youth would discuss how uncomfortable they were with Africa constantly coming up in school as being linked to HIV.

This fear of being targeted contributes to the “silencing of the topic and the resistance to seek testing,” Frohlick said. Some people may think that when you talk about these things it means you have HIV, which for the African youth is particularly stigmatizing since their bodies are already associated with HIV. As a result the message these youth were retaining was “just use condoms” to be a good Canadian, leading to problems such as improper use of condoms.

Dr. Leigh Anne Shafer’s (internal medicine) work examined the inequality in cervical cancer screening between First Nations and non-First Nations girls. Non-First Nations girls are vaccinated for HPV at a rate 1.4 times that of First Nations girls. First Nations women are more likely to contract cervical cancer, caused by HPV, than those whom are First Nations (34/100,000 compared to 9.5/100,000).  Shafer explored what impact these inequalities in health-care utilization might have on future cervical cancer incidence among all Manitoba women. She and her colleagues used “compartmental modelling” to simulate groups of men and women. They compared the impact of low versus high vaccination rates on how HPV infection spread.

Their model closely matched current data on cervical cancer and assumed some ethnic mixing when choosing partners.

The study’s conclusion is that we must find a way for all girls to have equal coverage against HPV in order to see a significant decline in cervical cancer incidence.

Discussion

Frohlick said some young women were having a hard time asking about condom use. Do they just feel they can’t ask or are they not having sex?

Age and religion both had to do with if they were having sex or not. But we did have to be careful in terms of our own understanding of sex. Some of these people were doing things we would consider sex, but they do not.

How did Frohlick choose focus groups?

We relied on our research co-ordinator, who is part of the Sudanese community. Later in the project, we met a student who wanted to come on board. So, through that person we met more youth. We also had a poster campaign to attract more people.

Did you find that the youth were able to overcome their discomfort within the group?

We did design it for multiple conversations with the same group. We engaged in interviews as well. In our new project, we are going to go into their communities to talk.

It strikes me as odd to give an HPV vaccine to an 11-year-old girl. How do we discuss this with them?

I know a couple of kids in Grade 6 and they can understand that eventually they will be sexually active. HPV is a very infectious virus and almost every person here has had it. This is why it’s so important to immunize people before they are active.

 

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