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.