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RESEARCH ARTICLE

Sexual health knowledge and behaviour of young Sudanese Queenslanders: a cross-sectional study

Judith Dean A B F , Marion Mitchell B C , Donald Stewart D and Joseph Debattista E
+ Author Affiliations
- Author Affiliations

A School of Public Health, Faculty of Medicine, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia.

B School of Nursing and Midwifery, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Nathan Campus, 170 Kessels Road, Nathan, Qld 4111, Australia.

C Nurse Practice Development Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Qld 4102 Australia.

D School of Medicine, South Bank Campus, Griffith University, PO Box 3370, South Brisbane, Qld 4101, Australia.

E Metro North Public Health Unit, Metro North Hospital and Health Service, Queensland Government, Bryden Street, Windsor, Qld 4030, Australia.

F Corresponding author. Email: j.dean4@uq.edu.au

Sexual Health 14(3) 254-260 https://doi.org/10.1071/SH16171
Submitted: 16 September 2016  Accepted: 18 November 2016   Published: 20 January 2017

Abstract

Background: Forced migration is associated with sexual vulnerability. However, little is known about the sexual health literacy and needs of refugee-background youth post resettlement. Methods: Conducted in partnership with the Queensland Sudanese community, this study used a cross-sectional survey to explore the sexual health knowledge, attitudes and behaviours of a convenience sample of 16- to 24-year-old Sudanese-background youth in Australia (n = 229). Results: Sexually transmissible infection (STI) and HIV knowledge scores were generally low, although they were found to significantly improve the longer participants had lived in Australia (P < 0.001). Female participants reported significantly higher levels of both STI and HIV knowledge compared with the male cohort (P < 0.001). The aggregated sexual risk behaviour score suggests generally low levels of risk-taking behaviour. However, of the 140 sexually active participants, 3.1% reported a STI diagnosis, 9.0% reported sex leading to a pregnancy and 33.1% reported they had experienced unwanted sex. Participants also reported engaging in behaviours such as anal sex (33%) and sharing injecting drug equipment. Conclusions: Patterns of sexual behaviour among this predominately refugee-background group are not dissimilar to those of other young Australians. Nonetheless, the self-reported patterns of risk behaviour combined with the low and inaccurate levels of sexual health knowledge suggest this group of young people remain sexually vulnerable, particularly early within their resettlement experience. Culturally and contextually informed sexual health interventions are needed early within the resettlement experience.

Additional keywords: adolescents, Australia, refugee, sexual behaviour.


References

[1]  Commonwealth of Australia. Fact sheet 60 – Australia’s refugee and humanitarian program. Canberra: Department of Immigration and Border Protection, Commonwealth of Australia; 2013.

[2]  Austin J, Guy S, Lee-Jones L, McGinn T, Schlecht J. Reproductive health: a right for refugees and internally displaced persons. Reprod Health Matters 2008; 16 10–21.
Reproductive health: a right for refugees and internally displaced persons.Crossref | GoogleScholarGoogle Scholar |

[3]  Tompkins M, Smith L, Jones K, Swundell S. HIV education needs among Sudanese immigrants and refugees in the midwestern United States. AIDS Behav 2006; 10 319–23.
HIV education needs among Sudanese immigrants and refugees in the midwestern United States.Crossref | GoogleScholarGoogle Scholar |

[4]  McMichael C. Promoting sexual health amongst resettled youth with refugee backgrounds. Melbourne: Refugee Health Research Centre, La Trobe University; 2008.

[5]  Ali MM, Cleland JG, Carael M. Sexual risk behaviour in urban populations of Northeastern Africa. AIDS Behav 2001; 5 343–52.
Sexual risk behaviour in urban populations of Northeastern Africa.Crossref | GoogleScholarGoogle Scholar |

[6]  Ali M, Pett C. A sexual and reproductive health education initiative for young Sudanese refugees in urban Egypt. Community Dev 2005; 40 192–200.
A sexual and reproductive health education initiative for young Sudanese refugees in urban Egypt.Crossref | GoogleScholarGoogle Scholar |

[7]  Lemoh CN, Biggs B, Hellard M. Working with West African migrant communities on HIV prevention in Australia. Sex Health 2008; 5 313–4.
Working with West African migrant communities on HIV prevention in Australia.Crossref | GoogleScholarGoogle Scholar |

[8]  Queensland Government. Community profiles for health care providers – Sudanese Australians. Brisbane: Queensland Health; 2011.

[9]  Commonwealth of Australia. Sudanese community profile. Canberra: Department of Immigration and Citizenship; 2007.

[10]  Holt PM, Daly MW. A history of the Sudan: from the coming of Islam to the present day, 6th edn. Harlow, UK: Pearsons Education Limited; 2011.

[11]  Fishbein M. The role of theory in HIV prevention. AIDS Care 2000; 12 273–8.
The role of theory in HIV prevention.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvhslKgtg%3D%3D&md5=b65d327745f7a16b7d9a2a5db42e0555CAS |

[12]  Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice, 9th edn. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2012.

[13]  Dean JA, Wollin J, Stewart D, Debattista J, Mitchell M. Hidden yet visible: methodological challenges researching sexual health in Sudanese refugee communities. Cult Health Sex 2012; 14 911–24.
Hidden yet visible: methodological challenges researching sexual health in Sudanese refugee communities.Crossref | GoogleScholarGoogle Scholar |

[14]  Bloch A. Methodological challenges for national and multi-sited comparative survey research. J Refug Stud 2007; 20 230–47.
Methodological challenges for national and multi-sited comparative survey research.Crossref | GoogleScholarGoogle Scholar |

[15]  Temple B, Moran R. Introduction. In Temple B, Moran R, editors. Doing research with refugees: issues and guidelines. Bristol: The Policy Press, University of Bristol; 2006. pp. 1–20.

[16]  Smith AMA, Agius PA, Dyson S, Mitchell A, Pitts M. Secondary students & sexual health 2002: Results of the 3rd National Survey of Australian Secondary Students HIV/AIDS and Sexual Health. Melbourne: Australian Research Centre in Sex, Health & Society, La Trobe University; 2003.

[17]  Bhui K, Khatib Y, Viner R, Klineberg E, Clark C, Head J, Stansfeld S. Cultural identity, clothing and common mental disorder: a prospective school-based study of white British and Bangladeshi adolescents. J Epidemiol Community Health 2008; 62 435–41.
Cultural identity, clothing and common mental disorder: a prospective school-based study of white British and Bangladeshi adolescents.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c3ltlCmug%3D%3D&md5=1b1b1b80f1c94dce6d5f4d1af5524022CAS |

[18]  Berry JW. Lead article: immigration, acculturation, and adaptation. Appl Psychol 1997; 46 5–68.

[19]  Aday LA, Cornelius LJ. Designing and conducting health surveys: a comprehensive guide, 3rd edn. San Francisco: Jassey-Bass; 2006.

[20]  Agius PA, Pitts MK, Smith AMA, Mitchell A. Sexual behaviour and related knowledge among a representative sample of secondary school students between 1997 and 2008. Aust N Z J Public Health 2010; 34 476–81.
Sexual behaviour and related knowledge among a representative sample of secondary school students between 1997 and 2008.Crossref | GoogleScholarGoogle Scholar |

[21]  Marston C, King E. Factors that shape young people’s sexual behaviour: a systematic review. Lancet 2006; 368 1581–6.
Factors that shape young people’s sexual behaviour: a systematic review.Crossref | GoogleScholarGoogle Scholar |

[22]  Tabachnick BG, Fidell LS. Using multivariate statistics, 6th edn. New Jersey: Pearson Education Inc; 2013.

[23]  Lucas D, Jamali M, Edgar B. The Sudan-born in Australia: a statistical profile. Australasian Rev African Studies 2011; 32 10–24.

[24]  Smith AMA, Agius PA, Mitchell A, Barrett C, Pitts M. Secondary students and sexual health 2008: results of the 4th national survey of Australian secondary students, HIV/AIDS and sexual health. Melbourne: Australian Research Centre in Sex, Health & Society, La Trobe University; 2009.

[25]  Mitchell A, Patrick K, Heywood W, Blackman P, Pitts M. 5th national survey of Australian secondary students and sexual health 2013. (ARCSHS Monograph Series No. 97). Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University; 2014.

[26]  Kotchick BA, Shaffer A, Miller KS, Forehand R. Adolescent sexual risk behavior: a multi-system perspective. Clin Psychol Rev 2001; 21 493–519.
Adolescent sexual risk behavior: a multi-system perspective.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MzltVGrtA%3D%3D&md5=90f2b040cf1fae6b286df5fc9f63dbd6CAS |

[27]  Fagan P, McDonell P. Knowledge, attitudes and behaviours in relation to safe sex, sexually transmitted infections (STI) and HIV/AIDS among remote living north Queensland youth. Aust N Z J Public Health 2010; 34 S52–6.
Knowledge, attitudes and behaviours in relation to safe sex, sexually transmitted infections (STI) and HIV/AIDS among remote living north Queensland youth.Crossref | GoogleScholarGoogle Scholar |

[28]  Fairley CK. Priorities in sexual health. In Russell D, Bradford D, Fairley CK, editors. Sexual health medicine, 2nd edn. Melbourne: IP Communications; 2011. pp. 3–13.

[29]  Montaño DE, Kasprzyk D. Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. In Glanz K, Rimer BK, Viswanath K, editors. Health behaviour and health education theory, research, and practice, 4th ed. San Francisco: Josseu-Bass, John Wiley & Sons; 2008. pp. 67–96.

[30]  Kang M. Adolescent sexual health. In Russell D, Bradford D, Fairley CK, editors. Sexual health medicine, 2nd edn. Melbourne: IP Communications; 2011. pp. 332–40.

[31]  McBride KR, Fortenberry JD. Heterosexual anal sexuality and anal sex behaviors: a review. J Sex Res 2010; 47 123–36.
Heterosexual anal sexuality and anal sex behaviors: a review.Crossref | GoogleScholarGoogle Scholar |

[32]  Zeidan ZA, Abdu MZ, Gadour MO, Bhairy NM. Condom use among illegal multi-partners females in the Sudan. Sudan J Med Sci 2011; 6 195–8.

[33]  Duby Z, Colvin C, Kitungulu B, editors. Heterosexual anal sex: knowledge, attitudes and practice in 5 East African communities. 1st International HIV Social Science and Humanities Conference (IAOHSS) – Locating the Social. 11–13 June 2011; Durban, South Africa. Durban: Association for the Social Sciences and Humanities in HIV (ASSHH); 2011.

[34]  Street A. HIV: natural history and treatment. In Russell D, Bradford D, Fairley CK, editors. Sexual health medicine. Melbourne: IP Communications; 2011. pp. 234–49.

[35]  Lemoh CN, Baho S, Grierson J, Hellard M, Street A, Biggs B-A. African Australians living with HIV: a case series from Victoria. Sex Health 2010; 7 142–8.
African Australians living with HIV: a case series from Victoria.Crossref | GoogleScholarGoogle Scholar |

[36]  Scott J, Averbach S, Modest AM, Hacker MR, Cornish S, Spencer D. An assessment of gender inequitable norms and gender-based violence in South Sudan: a community-based participatory research approach. Confl Health 2013; 7 4
An assessment of gender inequitable norms and gender-based violence in South Sudan: a community-based participatory research approach.Crossref | GoogleScholarGoogle Scholar |

[37]  Tankink MTA. The silence of South-Sudanese women: social risks in talking about experiences of sexual violence. Cult Health Sex 2013; 15 391–403.
The silence of South-Sudanese women: social risks in talking about experiences of sexual violence.Crossref | GoogleScholarGoogle Scholar |

[38]  Birukila GJ. Culture, risk and HIV: the case of black African migrants and refugees in Christchurch, New Zealand. Dunedin: [Doctor of Philosophy] Department of Public Health and General Practice, University of Otago; 2012.

[39]  de Visser RO, Smith AMA, Rissel CE, Richters J, Grulich AE. Sex in Australia: experiences of sexual coercion among a representative sample of adults. Aust N Z J Public Health 2003; 27 198–203.
Sex in Australia: experiences of sexual coercion among a representative sample of adults.Crossref | GoogleScholarGoogle Scholar |

[40]  Agius PA, Taft A, Hemphill S, Toumbourou J, McMorris B. Excessive alcohol use and its association with risky sexual behaviour: a cross-sectional analysis of data from Victorian secondary school students. Aust N Z J Public Health 2013; 37 76–82.
Excessive alcohol use and its association with risky sexual behaviour: a cross-sectional analysis of data from Victorian secondary school students.Crossref | GoogleScholarGoogle Scholar |

[41]  Gloppen KM, David-Ferdon C, Bates J. Confidence as a predictor of sexual and reproductive health outcomes for youth. J Adolesc Health 2010; 46 S42–58.
Confidence as a predictor of sexual and reproductive health outcomes for youth.Crossref | GoogleScholarGoogle Scholar |

[42]  Hebbani A, Obijiofor L, Bristed H. Generational differences faced by Sudanese refugee women settling in Australia. Intercult Commun Stud 2009; 18 66–82.

[43]  Kirby DB, Laris BA, Rolleri LA. Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world. J Adolesc Health 2007; 40 206–17.
Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world.Crossref | GoogleScholarGoogle Scholar |

[44]  Smith AMA, Pitts M. Researching the margins: an introduction. In Pitts M, Smith A, editors. Researching the margins strategies for ethical and rigorous research with marginalised communities. Hampshire, UK: Palgrave MacMillan; 2007. pp. 3–41.

[45]  White B, Day C, Maher L. Self reported risk behaviour among injecting drug users: self verses assisted questionnaire completion. AIDS Care 2007; 19 441–7.
Self reported risk behaviour among injecting drug users: self verses assisted questionnaire completion.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2s3ksVemsw%3D%3D&md5=5493dc3b4c233ac8331c3def59524863CAS |