Part 2:  Sexual and Reproductive Health Issues of Concern to Aboriginal People

Unfortunately, for many youth, feeling good about ourselves, building healthy relationships, making good choices that affect our sexual health, and figuring out if we are heterosexual, gay, lesbian, bisexual or transgendered, is a struggle. Too many young people become sexually active without knowing the facts and the risks involved. To overcome the serious issues that affect youth, such as teen pregnancy, sexual violence, involvement in the sex trade, depression, suicide and HIV/AIDS, communities need to actively work on the concerns of youth and to involve them in the design and delivery of programs that raise awareness and provide support.¹ (click here for footnote)



There’s so much going on in our communities and a lot of the time we don’t want to talk about those issues, about sexuality. Our communities are sometimes not ready to hear them … I wish there was someone I could have talked to … they could have helped me a
                      whole lot.² (click here for footnote)

I think in smaller communities there are some judgments made on you if you are Aboriginal and going to a non-Native health care worker who may have looked at the statistics of Aboriginal people and might think that there is no hope. Also, if you were raised not to talk about sex, the worker will need a lot of patience and have to be able to sort of "read" that the person may want to say something but isn’t. And it might take a few visits or appointments to get to the heart of the matter. And also, there might be racism in the young person’s home about "white" people not understanding.
Young Métis woman from northern British Columbia

Supporting Youth in Sexual Health

You have the opportunity to work with youth to identify and address sexual health problems that touch their lives. Youth are the experts on what they need to know, so ask them! Aboriginal youth can and want to make a contribution to their communities and services. Get them involved in raising awareness among their peers about choosing how and when to be sexually active and when to become pregnant; and about being safe from sexually transmitted infections, violence and sexual exploitation. Involving them will help to strengthen their identities and build their self-esteem and decision-making skills so they can make healthy choices.

Pilot coordinator Lerinda says:
I don’t think we give youth (14-18 years old) enough credit for what they already know. They pick up so much information from school, health centres, posters, friends and family. I believe that our role as health educators is to discover that knowledge and clear up any myths or misunderstandings in a positive way.
Lerinda Swain, Aboriginal Health Program, B.C. Women’s Hospital and Health Services, Vancouver, British Columbia

Self-Esteem

Self-esteem may be the most important element for sexual health. Everyone who works with and supports Aboriginal youth can find ways to create an affirming and positive environment that celebrates and builds on the strengths and self-worth of Inuit, First Nations and Métis youth.

Feelings of hopelessness can convince youth that nothing can make their lives any better or worse. They don’t have the emotional energy to make good long-term decisions. Low self-esteem and loneliness create in many youth a desperate desire for a sense of belonging. This can lead them to live very dangerously: taking physical and sexual risks, living in the moment, living for a "high."

Low self-esteem makes youth easy "prey" to those who tell them what they most want to hear: that they are loved, they are appreciated, they are understood and they will be taken care of.³ (click here for footnote)

Many Aboriginal children who grow up in non-Aboriginal foster or adoptive homes may experience problems linked to low self-esteem.

The Aboriginal child raised in a non-Native household may seem to thrive during the early years. However, in late childhood and adolescence, he begins to wonder ... regarding his roots ... With low self-esteem and a confused sense of self, the child is ill-equipped to form healthy and mature relationships with others. He is then more likely to seek short term pleasures rather than more realistic long term goals.⁴ (click here for footnote)

Wanting to fit in, wanting love and affection, a lack of other options like schooling or a good job, the desire to start one’s own family where "things will be better than they were for me," little sex education that fits with Aboriginal youth experiences and culture, a lack of birth control and abortion services, or just someone to talk to — all these things can lead young people to be sexually active, and to get pregnant before they are ready. Early pregnancy has a huge effect on the parents, especially the mother. It is very difficult to continue in school, poverty is an almost sure outcome and the demands of parenting can overwhelm a young person. Youth need information and services to help them make sound choices about when to become sexually active, and when and if to become parents.

	Have someone like me ... tell the girls they don’t have to give in to sex because the guys won’t wait for you and they don’t really love you, because it’s true. Young Aboriginal teen father
Definitely wait to have sex in the first place. If my mom would have talked to me about sex a lot more than she did, I probably would have waited and I probably would have still been a virgin now. Young Aboriginal teen mother5 (click here for footnote)

Aboriginal youth are an important at-risk group for HIV/AIDS and sexually transmitted infections (STIs) such as chlamydia and gonorrhea. Poor living conditions, sexual risk taking and moving from one place to another, all add to the risk. Sharing intravenous drug needles has increased the risk not only of HIV/AIDS, but also of Hepatitis C, which many outreach workers now see as an emerging epidemic. STIs in Aboriginal youth often go undetected until serious harm has resulted.⁷ (click here for footnote)

Many communities have responded to the HIV/AIDS epidemic by developing prevention and support programs for Aboriginal and non-Aboriginal youth, and many resources now exist to help health care providers and organizations address this life-threatening issue.

Sexual Exploitation

Recent research shows us that up to 80 percent of youth who are in the sex trade report having been sexually abused.⁸ (click here for footnote)  Many Aboriginal youth who experience physical, sexual and or emotional abuse in their home lives, leave in search of a better life. Having nowhere to go and often few job skills, they join the growing numbers of Aboriginal youth who are sexually exploited on the streets. Cherry Kingsley, a former sex trade worker who recently completed a report on the sex trade, says many Aboriginal teens exchange sex for food and shelter. "It’s not even like they’re making money," she says. "They’re just kind of barely surviving. So, for a lot of young people, it’s just survival." ⁹ (click here for footnote)

We can help prevent young people from entering the sex trade by protecting them from violence and sexual abuse at home, offering safe and supportive places to live, and helping them with addictions and the legacy of sexual abuse. We can also help them while they are in the sex trade by providing non-judgmental services, such as protection from pregnancy and sexually transmitted diseases, general health care and referrals to other services.

One exciting example of a successful youth intervention is Kamamakus (Cree for butterfly), a youth performing troupe in Prince Albert, Saskatchewan. The troupe provides innovative education at schools and in the general public to address high-risk behaviours contributing to Hepatitis C, HIV/AIDS and other STIs, substance abuse and gangs. The troupe members have reached many youth through the telling of their stories. The self-esteem of each of the troupe members has blossomed, reflecting the metamorphosis of the butterfly. They have become peer counsellors and excellent role models for youth.

Kamamakus youth are all from difficult backgrounds, but we don’t let that stop us. We see it as an opportunity to teach others from our experiences, about how to prevent it from happening to them. We just want to help as many people as we can with our message of the prevention of Hep C and living a healthy lifestyle.
Kamamakus troupe members, Prince Albert, Saskatchewan

¹  Inclusion, Empowerment and Healing: National Youth Conference Summary Report, Assembly of First Nations, Ottawa, 1997, 
p. ii.  (back to paragraph)

²  Sacred Lives: Canadian Aboriginal Children and Youth Speak Out About Sexual Exploitation, Cherry Kingsley and Melanie Mark, Save the Children Canada, Vancouver, 2000, p. 28. Available at: www.savethechildren.ca/en/whatwedo/pdf/sacredlives.pdf  (back to paragraph)

³  Sacred Lives, p. 31.  (back to paragraph)

⁴  Our Way Home: A Report to the Aboriginal Health and Wellness Strategy on the Repatriation of Aboriginal Peoples Removed by the Child Welfare System [Ontario], Native Child and Family Services of Toronto, 1999, p. 75. Available at: www.nativechild.org/report.html   (back to paragraph)

⁵  Tenuous Connections: Urban Aboriginal Youth Sexual Health and Pregnancy, Ontario Federation of Indian Friendship Centres, Toronto, 2002, p. 55.  (back to paragraph)

⁶  "Team of Aboriginal Youth Spread the Word on AIDS and Sexual Health," AYN News, 2000 Archives, Aboriginal Youth Network. Available at: www.ayn.ca/news/0004/band_aids_aware.htm   (back to paragraph)

⁷  Sacred Lives, p. 31.  (back to paragraph)

⁸  Sacred Lives, p. 14.  (back to paragraph)

⁹  "Youth Trade Sex for Survival," Inclusion, Empowerment and Healing: National Youth Conference Summary Report, Assembly of First Nations, Ottawa, 1997, p. iii.  (back to paragraph)

¹⁰  Sacred Lives, p. 31.  (back to paragraph)