Improving engagement with sexual and reproductive health services among young African migrants in Australia
Humaira Maheen
A * , Negin Mirzaei Damabi B and Zohra S. Lassi B
A
B
Abstract
Sexual and reproductive health (SRH) services are underutilised by young people from migrant and refugee backgrounds in many Western countries, including Australia. Young African migrants, a growing demographic in Australia, face unique challenges, including stigma associated with seeking sexual health care and limited sexual health literacy, which lead to adverse SRH outcomes. The study aims to (1) develop an understanding of young African migrants’ knowledge of existing sexual health services in Australia and (2) explore young people’s perceptions of youth-friendly SRH services for optimal engagement by young migrants from African backgrounds.
A qualitative study was conducted in Melbourne, Australia, in 2019, using three participatory workshops involving 30 young African migrants aged 18–24 years. The data was analysed thematically.
Thematic analysis identified three key themes: (1) lack of visibility and information of existing sexual health services affects service use, (2) cultural stigma associated with sexual health affects help-seeking and health service engagement, and (3) key attributes of youth-friendly SRH care for young African migrants. None of the participants were aware of sexual health services in Australia. Although general practitioners were the most commonly known healthcare providers, many participants avoided seeking SRH care from them due to concerns about confidentiality. Participants emphasised the importance of accessible, youth-friendly SRH services, recommending culturally informed approaches and highlighting preferences for provider characteristics, such as younger age, strong confidentiality assurances, and gender-specific options in provider selection.
The lack of awareness about sexual health services among young African migrants hinders their ability to access appropriate care. Efforts to promote SRH services should include targeted, culturally sensitive outreach and clear communication to address misconceptions and barriers. Adopting a cultural lens in designing youth-friendly SRH services may enhance their utilisation and improve SRH outcomes among this population.
Keywords: adolescents, African, migrants, sex education, sexual and reproductive health, stigma, young people, youth friendly services.
References
1 United Nations. World Youth Report – Youth and 2030 Agenda For Sustainable Development New York; 2018. Available at https://www.un.org/development/desa/youth/wp-content/uploads/sites/21/2018/12/WorldYouthReport-2030Agenda.pdf [cited 14 December 2023]
2 Chandra-Mouli V, Svanemyr J, Amin A, Fogstad H, Say L, Girard F, et al. Twenty years after International Conference on Population and Development: where are we with adolescent sexual and reproductive health and rights? J Adolesc Health 2015; 56(1): S1-6.
| Crossref | Google Scholar |
3 Manirankunda L, Loos J, Alou TA, Colebunders R, Nöstlinger C. “It’s better not to know”: perceived barriers to HIV voluntary counseling and testing among sub-Saharan African migrants in Belgium. AIDS Educ Prev 2009; 21(6): 582-93.
| Crossref | Google Scholar | PubMed |
4 Newton-Levinson A, Leichliter JS, Chandra-Mouli V. Sexually transmitted infection services for adolescents and youth in low- and middle-income countries: perceived and experienced barriers to accessing care. J Adolesc Health 2016; 59(1): 7-16.
| Crossref | Google Scholar | PubMed |
5 Rizvi F, Williams J, Maheen H, Hoban E. Using social ecological theory to identify factors associated with risky sexual behavior in cambodian adolescent girls and young women aged 10 to 24 years: a systematic review. Asia Pac J Public Health 2020; 32(2-3): 71-80.
| Crossref | Google Scholar | PubMed |
6 World Health Organization. Global research agenda on health, migration and displacement: strengthening research and translating research priorities into policy and practice; 2023. Available at https://www.who.int/publications/i/item/9789240082397
7 Juang LP, Schachner MK. Cultural diversity, migration and education. Int J Psychol 2020; 55(5): 695-701.
| Crossref | Google Scholar | PubMed |
8 Maheen H, Chalmers K, Khaw S, McMichael C. Sexual and reproductive health service utilisation of adolescents and young people from migrant and refugee backgrounds in high-income settings: a qualitative evidence synthesis (QES). Sex Health 2021; 18(4): 283-93.
| Crossref | Google Scholar |
9 Botfield J, Newman C, Kang M, Zwi A. Talking to migrant and refugee young people about sexual health in general practice. Aust J Gen Pract 2018; 47(8): 564-9.
| Crossref | Google Scholar | PubMed |
10 Adedimeji AA, Asibon A, O’Connor G, Carson R, Cowan E, McKinley P, et al. Increasing HIV testing among African immigrants in Ireland: challenges and opportunities. J Immigr Minor Health 2015; 17: 89-95.
| Crossref | Google Scholar | PubMed |
11 Baroudi M, San Sebastian M, Hurtig A-K, Goicolea I. The perception of youth health centres’ friendliness: does it differ between immigrant and Swedish-Scandinavian youths? Eur J Public Health 2020; 30(4): 780-5.
| Crossref | Google Scholar |
12 Davidson N, Hammarberg K, Romero L, Fisher J. Access to preventive sexual and reproductive health care for women from refugee-like backgrounds: a systematic review. BMC Public Health 2022; 22(1): 403.
| Crossref | Google Scholar |
13 Suphanchaimat R, Kantamaturapoj K, Putthasri W, Prakongsai P. Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens. BMC Health Serv Res 2015; 15: 390.
| Crossref | Google Scholar |
14 Australian Bureau of Statistics. Census. 2021; Available at Available at https://www.abs.gov.au/census [cited 7 January 2023].
| Google Scholar |
15 Cook J, Waite L. ‘I think I’m more free with them’—Conflict, Negotiation and Change in Intergenerational Relations in African Families Living in Britain. J Ethn Migr Stud 2016; 42(8): 1388-402.
| Crossref | Google Scholar |
17 Renzaho AMN, Dhingra N, Georgeou N. Youth as contested sites of culture: the intergenerational acculturation gap amongst new migrant communities – parental and young adult perspectives. PLoS ONE 2017; 12(2): e0170700.
| Crossref | Google Scholar |
18 Mwanri L, Okyere E, Pulvirenti M. Intergenerational conflicts, cultural restraints and suicide: experiences of young African people in Adelaide, South Australia. J Immigr Minor Health 2018; 20: 479-84.
| Crossref | Google Scholar | PubMed |
19 Dean J, Mitchell M, Stewart D, Debattista J. Sexual health knowledge and behaviour of young Sudanese Queenslanders: a cross-sectional study. Sex Health 2017; 14(3): 254-60.
| Crossref | Google Scholar | PubMed |
20 McMichael C, Gifford S. Narratives of sexual health risk and protection amongst young people from refugee backgrounds in Melbourne, Australia. Cult Health Sex 2010; 12(3): 263-77.
| Crossref | Google Scholar |
22 Bittleston H, Hocking JS, Coombe J, Temple-Smith M, Goller JL. Young Australians’ receptiveness to discussing sexual health with a general practitioner. Aust J Prim Health 2023; 29: 587-95.
| Crossref | Google Scholar | PubMed |
23 Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3(2): 77-101.
| Crossref | Google Scholar |
24 Rose SB, Garrett SM, McKinlay EM, Morgan SJ, Bell S. ‘Be nice to us, we’re still learning’: an online survey of young people in Hawkes Bay, New Zealand, about unmet need for sexual health care and improving access to services. Sex Health 2021; 18(5): 394-404.
| Crossref | Google Scholar | PubMed |
25 Australian Institute of Health and Welfare. Demonstration projects for improving sexual health in Aboriginal and Torres Strait Islander youth: evaluation report; 2013. Available at https://www.aihw.gov.au/reports/indigenous-australians/demonstration-projects-for-improving-sexual-health/contents/publication
26 Mikhailovich K, Arabena K. Evaluating an indigenous sexual health peer education project. Health Promot J Aust 2005; 16(3): 189-93.
| Crossref | Google Scholar |
27 Amroussia N. Providing sexual and reproductive health services to migrants in southern Sweden: a qualitative exploration of healthcare providers’ experiences. BMC Health Serv Res 2022; 22(1): 1562.
| Crossref | Google Scholar |
28 Rawson HA, Liamputtong P. Culture and sex education: the acquisition of sexual knowledge for a group of Vietnamese Australian young women. Ethn Health 2010; 15(4): 343-64.
| Crossref | Google Scholar | PubMed |
29 Rogers C, Earnest J. A cross-generational study of contraception and reproductive health among Sudanese and Eritrean women in Brisbane, Australia. Health Care Women Int 2014; 35(3): 334-56.
| Crossref | Google Scholar |
30 Kennedy EC, Bulu S, Harris J, Humphreys D, Malverus J, Gray NJ. “Be kind to young people so they feel at home”: a qualitative study of adolescents’ and service providers’ perceptions of youth-friendly sexual and reproductive health services in Vanuatu. BMC Health Serv Res 2013; 13(1): 455.
| Crossref | Google Scholar |
31 Kaczkowski W, Swartout KM. Exploring gender differences in sexual and reproductive health literacy among young people from refugee backgrounds. Cult Health Sex 2020; 22(4): 369-84.
| Crossref | Google Scholar | PubMed |
32 Inoue K, Kelly M, Bateson D, Rutherford A, Stewart M, Richters J. Contraceptive choices and sexual health of Japanese women living in Australia: a brief report from a qualitative study. Aust Fam Physician 2016; 45(7): 523-7.
| Google Scholar | PubMed |
