title: Abuse of power in relationships and sexual health.
abstract: STI rates are high for First Nations in Canada and the United States. Our objective was to understand the context, issues, and beliefs around high STI rates from a nêhiyaw (Cree) perspective. Twenty-two in-depth interviews were conducted with 25 community participants between March 1, 2011 and May 15, 2011. Interviews were conducted by community researchers and grounded in the Cree values of relationship, sharing, personal agency and relational accountability. A diverse purposive snowball sample of community members were asked why they thought STI rates were high for the community. The remainder of the interview was unstructured, and supported by the interviewer through probes and sharing in a conversational style. Modified grounded theory was used to analyze the narratives and develop a theory. The main finding from the interviews was that abuse of power in relationships causes physical, mental, emotional and spiritual wounds that disrupt the medicine wheel. Wounded individuals seek medicine to stop suffering and find healing. Many numb suffering by accessing temporary medicines (sex, drugs and alcohol) or permanent medicines (suicide). These medicines increase the risk of STIs. Some seek healing by participating in ceremony and restoring relationships with self, others, Spirit/religion, traditional knowledge and traditional teachings. These medicines decrease the risk of STIs. Younger female participants explained how casual relationships are safer than committed monogamous relationships. Resolving abuse of power in relationships should lead to improvements in STI rates and sexual health.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, 155 College St., 6th Floor, Toronto, Ontario M5T 3M7, Canada. Electronic address: dionne.gesink@utoronto.ca.
authors.forename: Dionne
authors.initials: D
authors.lastname: Gesink
authors.affiliation: Blue Quills First Nations College, Box 279, St. Paul, Alberta T0A 3A0, Canada. Electronic address: lanawhiskeyjack@gmail.com.
authors.forename: Lana
authors.initials: L
authors.lastname: Whiskeyjack
authors.affiliation: Blue Quills First Nations College, Box 279, St. Paul, Alberta T0A 3A0, Canada. Electronic address: terricardinal@hotmail.com.
authors.forename: Terri
authors.initials: T
authors.lastname: Suntjens
authors.affiliation: University of Toronto, 155 College St., Toronto, Ontario M5T 3M7, Canada. Electronic address: alanna.mihic@gmail.com.
authors.forename: Alanna
authors.initials: A
authors.lastname: Mihic
authors.affiliation: Saddle Lake Health Center, P.O. Box 160, Saddle Lake, Alberta T0A 3T0, Canada. Electronic address: priscillamcgilvery@yahoo.com.
authors.forename: Priscilla
authors.initials: P
authors.lastname: McGilvery
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000208:ethnology; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000523:psychology; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D011209:Power, Psychological; D012742:Sex Offenses / Q000208:ethnology / Q000523:psychology; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology*; D000074384:Sexual Health; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000523:psychology; D013405:Suicide / Q000208:ethnology / Q000523:psychology; D014481:United States / Q000208:ethnology; D055815:Young Adult
keywords: Abuse of power; Indigenous; Sexual abuse; Sexual health; Sexually transmitted infections; Suicide; Trauma