Indigenous Mothers' Perspective on Sexual Health in Northwest Territories, Canada: Results from the Maternal and Infant Health Project.

Purpose: In Northwest Territories (NWT), Canada, infection rates for chlamydia, gonorrhea, and syphilis are three to ten times higher than the national averages and have been steadily increasing. However, data are scarce on the socioeconomic, psychological, and behavioural factors associated with the proliferation of sexually transmitted infections (STIs) in NWT. To this extent, this study explores Indigenous mothers' perspectives on sexual health, STI risk factors and healthcare-seeking behaviours in NWT.

Methods: Quantitative and qualitative data were collected using a semi-structured questionnaire. Participants consisted of Indigenous mothers who were pregnant or had given birth within three years.

Results: Of the 161 participants, with a mean age of 29.61 years, 70.81% lived with a partner, and 93.17% had given birth within the previous three years. Participants felt STIs were a concern (68.32%) and felt comfortable asking a male partner for safe sexual relations (67.70%). The healthcare system was the main source of STI information for most participants (83.85%). The main STI risk factors participants mentioned were young age, unsafe sexual relations, and substance use. Participants reported embarrassment, protecting personal and familial well-being, and confidentiality as factors affecting STI healthcare-seeking behaviour.

Conclusion: STIs result from an interaction between age, sexual behaviour, substance use, health literacy, and the historical and sociocultural contexts stigmatizing STIs and impacting women's abilities to demand safe sexual relations. Understanding these factors in a remote Indigenous context is vital to designing and implementing effective health and social interventions to reduce the prevalence of STIs in NWT.