“I Like to Think I’m a Pretty Safe Guy but Sometimes a 40-Pounder* Will Change That”: A Mixed Methods Study of Substance Use and Sexual Risk Among Aboriginal Young People

We conducted a mixed methods study to explore links between substance use and sexual risk among Aboriginal young people in British Columbia, Canada. Individual in-depth interviews were conducted in 2004–2005 with 30 young people ages 15–19; we present a descriptive thematic analysis. Data from a 2003 provincially representative survey that included 2,467 Aboriginal young people attending secondary school were used to model relationships between substance use and sexual behaviour outcomes. Young people perceived that substance use affected community and extended family relationships and could shape behaviour during sexual encounters. Survey data show different age trajectories of risk. For young men, there was a strong and consistent linear relationship between substance use and potentially risky sexual behaviour across all age groups. For women, using more substances at younger but not older ages was a strong marker of sexual initiation. Using more substances in older but not younger age groups was a strong indicator for having more sexual partners. For both young women and young men, lifetime substance use and substance use at last sexual encounter did not predict condom use. Interventions must consider the effects of substance use on community structures and family relationships in addition to individual risk