RESUMO
OBJECTIVE: To gain some understanding of the attitudes and behaviours of Indigenous young people in Townsville concerning relationships, contraception and safe sex. DESIGN: Cross-sectional study using a computer-assisted self-administered survey and single-sex focus group discussions designed by a Young Mums' Group operating on participatory action principles and acting as peer interviewers. PARTICIPANTS AND SETTING: 171 Indigenous students in Years 9-11 at three high schools and 15 residents of a homeless youth shelter in Townsville, Queensland, 27 April - 8 December 2004. MAIN OUTCOME MEASURES: Self-reported attitudes and behaviour about relationships, sexual intercourse and contraception. RESULTS: 84/183 participants (45.9%) reported past sexual intercourse, with 56.1% commencing intercourse at age 13-14 years. The likelihood of having had sex increased with being male (P=0.001), increasing age, increased perceived sexual activity of peer group (both P=0.000), and drinking alcohol at least weekly (P=0.015). Young women were more likely to report unwanted sexual touching (P=0.031), and less likely to report enjoying sexual intercourse (P=0.001). The main qualitative themes concerned females' reputations, coercion, and denial of female desire. Only 49/80 participants (61.3%) reported always using condoms. The main reasons for not using contraception were "just not thinking about it", shame, and problems with access. Despite having reasonable knowledge about contraception, most lacked the confidence and negotiation skills to communicate with partners about condom use. CONCLUSIONS: Like teenagers elsewhere, Indigenous teenagers in Townsville are becoming sexually active at a young age, and not practising safe sex reliably. The need to protect their reputations puts young women at risk by not being prepared for safe sex by carrying condoms.