Investigating the Structural and Socio-cultural Forces Affecting STI Testing and Treatment Among Youth in Northeastern BC

(2006 – 2007; BCMSF)

Principal Investigator: Jean Shoveller

Co-Investigator(s): Shira Goldenberg; Mieke Koehoorn; Aleck Ostry

BACKGROUND: Northeastern British Columbia is undergoing rapid in-migration of young, primarily male workers in response to the “boom” in the oil/gas industries. Chlamydia rates in this region exceed the provincial average by 32 percent.

OBJECTIVES: To document youth’s experiences with STIs and STI testing and to make recommendations to improve the accessibility of testing in remote, resource-extraction communities.

METHODS: We documented STI rates and service provision patterns and completed 8 weeks of ethnographic fieldwork. 30 in-depth interviews with youth (ages 15-25) and 16 interviews with health and social service providers were conducted. Fieldwork included observations and informal conversations with youth, health, education, and social service providers, and other community members. Participants were asked to describe their experiences with STI testing and completed a brief survey.

RESULTS: Mis-matches exist between available services and youth’s needs for STI testing. Study participants identified 5 key barriers to STI testing for youth: 1) limited opportunities to access STI testing; 2) geographic inaccessibility of clinics; 3) local social norms; 4) lack of information regarding STIs and STI testing; 5) negative interactions with service providers

IMPLICATIONS: The influx of transient workers in concert with the local booming economy is creating a sexual health crisis. This study documents serious barriers to STI testing among youth in Fort St. John, mainly: limited available testing services; clinic inaccessibility; local norms for sexual behaviour and STI testing; inadequate access to information; and negative interactions with service providers. These suggest a serious gap between the needs of youth for age- and place-sensitive STI testing, and the current capacity in Fort St. John to address these. Immediate action is needed to address youth’s needs for STI testing. University researchers, Northern Health Authority, OPTions for Sexual Health, and oil/gas industry are partnering to plan sexual health interventions in the region.

Based on our study results, we recommend the following areas for action: improve access; increase hours of operation, especially evenings and weekends; provide drop-in services at the public health unit; reach out to youth; launch an information campaign to promote sexual heath among young people (and to reduce stigma related to STIs); provide information, staff training, testing, and free condoms at oil and gas sites; cooperate with organizations in Fort St. John serving youth to advertise STI testing locations and hours; train local youth as volunteers to provide public education to promote sexual health; support local service providers; provide ongoing training (e.g., improving clinical rapport); build profile of service providers in the community (e.g., community recognition awards; local media)

Total: $49,488