Sexual Behaviour Profile of a Diverse Group of Urban Youth: An Analysis of the Toronto Teen Survey

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Abstract: The objective of this study was to document the sexual behaviour of an ethno-culturally diverse sample of 1,200 urban youth and to assess the association of their experience of 11 behaviours with such factors as age, gender, immigration, race, religion, location of sexual education and sexual orientation. Grouping of these behaviours into three "risk" categories also permitted a similar assessment based on the "highest" risk category that youth had experienced. The descriptive and statistical findings in relation to race, religion, immigration status, and sexual orientation provide a basis for strengthening sexual health programming for urban youth. They also highlight the need to pay close attention to issues of vulnerability and stereotyping when reflecting on who is and is not engaging in various sexual behaviours.

Acknowledgements: This study was supported by grants from the Ontario HIV Treatment Network, the Canadian Institutes of Health Research, the Centre for Urban Health Initiatives, and the Wellesley Institute. It was hosted by Planned Parenthood Toronto. We want to thank the entire Toronto Teen Survey Research Team for all their help in gathering, managing and analyzing the data: Susan Flynn, Crystal Layne, Dr. June Larkin, Dr. Robb Travers, Hazelle Palmer, Adinne Schwartz, Kristin McIlroy, Adrian Guta, Roxana Salehi, our amazing students and research assistants and our youth advisory committee. Finally, we want to express gratitude to the community partner agencies that hosted workshops, and the youth and service providers who participated in our research.

Introduction

The sexual behaviour of Canadian youth continues to be a major topic of interest for researchers, public health professionals, and policy-makers (Maticka-Tyndale, 2008; Rotermann, 2008; Saewyc, Taylor, Homma, & Ogilvie, 2008) with particular emphasis on trends associated with changes in risk behaviours related to sexual health. Research on ways to reduce such risks and to thereby avoid unwanted outcomes has focused largely on predictors of safer sex practices, such as the use of contraception and condoms (Doljanac & Zimmerman, 1998; Harvey, Henderson, & Branch, 2004; Kotchick, Shaffer, Forehand, & Miller, 2001; Santelli et al., 1997; Sieving, Bearinger, Resnick, Pettingell, & Skay, 2007).

To the extent that such studies on trends and predictors have drawn on demographically representative samples, the numbers of ethno-cultural minority youth and sexual minority youth have often been too small for analysis. As urban centres have become increasingly diverse and multi-cultural, public health professionals have recognized the need for sexual health promotion interventions that are effective and sensitive to the varied needs of these populations of youth (de Visser, 2005). Research on social and cultural predictors of sexual risk behaviour of youth is limited (Kotchick et al., 2001), but the available evidence has shown a relationship between an urban youth's environment and ethnic background and his/her sexual risk behaviour (Brewster, 1994; Everett et al., 2000). The present study sought to explore the associations between socio-demographic factors and sexual behaviour among a diverse sample of urban youth.

The present study

The Toronto Teen Survey was designed to engage and sample a large population of urban teens with the express intent of ensuring a sizeable representation of ethno-culturally and sexually diverse youth (Flicker et al., 2010). Our purpose in the present study was to document the sexual behaviour of these youth and to provide quantitative estimates of the relationship between socio-cultural factors (for example: age, gender, immigration status, race, religion, location of sexual education and sexual orientation) and other possible aspects of their behaviour. Although it is impossible to modify many socio-demographic predictors, it is hoped that identification of such associations will lead to targeted prevention efforts better attuned to the varied needs of this diverse population.

Methods

This report is based on data from the Toronto Teen Survey (TTS). Methodological details are provided elsewhere (Flicker et al., 2010; Flicker & Guta, 2008), but briefly, the TTS is a community-based research project that surveyed 1,216 youth living in Toronto, Ontario Canada between December 2006 and August 2007. A Youth Advisory Committee (YAC) was established early in the project and worked closely with the project team to develop the survey and administration protocol.

Respondents were sampled via pre-existing youth groups hosted by community health, recreation and social service agencies (for example, drop-in centers, summer camps, group homes, support groups) where Planned Parenthood Toronto had a pre-existing relationship providing sexual health promotion activities. The sampling strategy ensured that the respondents were from diverse cultural backgrounds reflecting the population of Toronto. A special effort was made to reach out to specialized youth services that targeted populations who experienced heightened vulnerability to poor sexual health outcomes (e.g., queer youth groups, a support program for young parents, a newcomer health club).

Members of the YAC led survey administration sessions; they introduced the survey, fielded questions with regard to the survey and facilitated a sexual health question and answer session at the conclusion of each survey administration session. All surveys were completed anonymously. Due to the fact that youth were sampled from spaces that were already offering sexual health workshops and that parental consent was not mandatory for involvement in these activities, parental consent was not required for participation in this minimal risk study. Nevertheless, careful assent procedures were followed and host agencies took on the "duty to report" abuse and/or suicidal ideation in the event that a young person disclosed. The TTS project underwent ethical review from both the University of Toronto and York University.

Participant characteristics

There were 31 respondents that did not complete the sexual experience question and hence the population available for analysis was 1,185 (labeled as Total Sample). Table 1 provides overall characteristics of all respondents (including those 31 respondents not included in subsequent analyses). Overall, the age of respondents is well distributed with slightly more female than male respondents (53.6% versus 44.7%). Eighty-seven percent of the respondents were either born in Canada (65.3%) or had lived in Canada for four or more years. The sample was racially diverse with only 14.4% identifying as White, 14.5% as East/Southeast Asian, 38.1% as Black and 12.9% identifying as multi-racial. With regard to religion, the sample has approximately equal proportions of catholic and protestant respondents at 27% each. Approximately 18% identified as having no religion. Ninety percent of the respondents indicated their sexual orientation as heterosexual.

Questionnaire

The survey had questions in several broad domains including demographics, sexual experience, use and barriers to use of sexual health clinics and sexual education. The target age group of the survey was 13- to 17-year-olds, although if members of the youth group were outside this age range, they were not precluded from completing the survey.

Sexual behaviour experience

Experience with different sexual behaviours was developed from a checklist based on the following stem question: "Have you had any of these sexual experiences?" Respondents were allowed to select all options that applied to them from a list of 11 behaviours (the 12th option was to check "I have not had any of these experiences"). Descriptive statistics are presented for youth who had engaged in each of the 11 behaviours, or none of them, in relation to the following covariates: age, gender, immigration, race, religion, location of sexual education and sexual orientation.

The descriptive findings are presented under three categorical …