Associations Between Environmental and Social Hazards, Self-Esteem, and Condom Use Self-Efficacy Among Northern and Indigenous Adolescents in Arctic Canada: Cross-Sectional Structural Equation Modeling Findings.

BackgroundWildfire exposure and co-occurring socio-environmental inequities may shape HIV and sexually transmitted infection (STI) vulnerabilities, yet this remains understudied in Canada's Northwest Territories (NWT). Guided by ecosocial theory, we examined associations between socio-environmental stressors and condom use self-efficacy (CUSE) among Northern and Indigenous adolescents.MethodsWe conducted a cross-sectional survey (2023-2024) with 290 adolescents (ages 13-18) across 12 NWT communities. Structural equation modeling examined associations among wildfire traumatic exposure severity, food insecurity, self-esteem, and CUSE, adjusting for gender, sexual orientation, Indigenous identity, and rural residency.ResultsGreater wildfire traumatic exposure severity was associated with higher food insecurity and lower self-esteem. Food insecurity was also associated with lower self-esteem, while self-esteem was associated with higher CUSE. Wildfire traumatic exposure severity and food insecurity were significantly indirectly associated with CUSE via self-esteem.ConclusionsHIV and STI prevention with NWT adolescents should address socio-environmental stressors and marginalization while supporting youth self-esteem.