Regional patterns of risk for sexually transmitted infections in British Columbia.

BACKGROUND: Although rates of sexually transmitted infection (STI) tend to be higher in urban Canada, the province of British Columbia has recently seen above-average rates in the northern health regions.

DATA AND METHODS: Data from the 2005 Canadian Community Health Survey were used to examine sexual behaviour risks by geography and age in British Columbia. Two outcomes were investigated: ever diagnosed with an STI, and did not use a condom during last sexual intercourse. Region was categorized as metropolitan and non-metropolitan (Northern, representing more rural and remote communities, and Southern). Multivariate logistic regression was used to determine associations between the two outcomes and region, age, and other socio-demographic variables. Normalized weights accounted for sampling design.

RESULTS: In adjusted analysis, older age (25 to 49) and being female were significantly associated with previously having an STI and not using a condom during last sex. Being a non-drinker was inversely associated with the former outcome, and being an occasional drinker was inversely associated with both outcomes, compared with being a regular drinker. When stratified by region, the relationship between older age and not using a condom was particularly strong in Northern non-metropolitan regions.

INTERPRETATION: The results highlight the importance of considering older individuals in the design of STI preventive interventions, particularly in non-metropolitan and rural and remote regions, where access to testing and treatment may be limited.