International students’ views on sexual health: a qualitative study at an Australian university
Anneka Parker A C , Peter Harris B and Bridget Haire AA Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, High Street, Kensington, NSW 2052, Australia.
B Office of Medical Education, University of New South Wales, High Street, Kensington, NSW 2052, Australia.
C Corresponding author. Email: anneka.parker@unsw.edu.au
Sexual Health 17(3) 231-238 https://doi.org/10.1071/SH19209
Submitted: 18 November 2019 Accepted: 8 January 2020 Published: 22 June 2020
Journal Compilation © CSIRO 2020 Open Access CC BY-NC
Abstract
Background: The number of international students at Australian universities is rapidly increasing, and they contribute significantly to Australia’s economy. However, concerns have been raised for the health and wellbeing of international students, and there is limited information concerning international students with regard to their sexual health. Methods: Overall, 13 individual semi-structured in-depth interviews were conducted with 13 international students at an Australian university, aiming to understand the views and experiences of international students with regard to their sexual health and wellbeing. The interviews were analysed thematically, generating four themes. Results: Participants had a varied understanding of sexual consent, which often included concerns about the practicalities of saying ‘no’ to unwanted sexual interactions and misinformation about the effect of reporting sexual misconduct on their privacy and visa status. Cultural and familial taboos were often inherited, but many participants described an evolution of personal views and attitudes regarding topics such as sex before marriage and same-sex relationships, which had occurred since moving to Australia. Participants expressed that they received large amounts of information about sexual health, but often lacked the skills to navigate that information and access relevant support. Conclusions: These data, along with participants’ suggestions for future support and education, are important for understanding the complex experiences of international students at Australian universities, and should be considered when implementing future sexual health education and support programs.
Additional keywords: consent, general practitioners, interviews, university health services, wellbeing.
References
[1] Department of Education and Training. End of year summary of international student data 2018. Canberra: Australian Government; 2018.[2] Department of Education and Training. Education export income by country 2018. Canberra: Australian Government; 2019.
[3] Poljski C, Quiazon R, Tran C. Ensuring rights: improving access to sexual and reproductive health services for female international students in Australia. J Int Stud 2014; 4 150–63.
[4] Australian Human Rights Commission. Principles to promote and protect the human rights of international students. Sydney: Australian Human Rights Commission; 2012. Available online at: https://www.humanrights.gov.au/our-work/book-principles-promote-and-protect-human-rights-international-students [verified 5 September 2019].
[5] Burton-Bradley R. Poor English, few jobs: are Australian universities using international students as ‘cash cows’? ABC News, 27 November 2018. Available online at: https://www.abc.net.au/news/2018-11-25/poor-english-no-jobs-little-support-international-students/10513590 [verified 5 March 2019].
[6] Shelton T, Renaldi E, Xiao B. World Suicide Prevention Day: how international students are vulnerable to mental health issues. ABC News, 10 September 2019. Available online at: https://www.abc.net.au/news/2019-09-10/suicide-prevention-day-pressures-facing-international-students/11476938 [verified 10 September 2019].
[7] McKenny L, Chen H, Blakkarly J. Sex education gap haunts Australia’s international students. SBS News, 1 March 2018. Available online at: https://www.sbs.com.au/news/sex-education-gap-haunts-australia-s-international-students [verified 18 March 2019].
[8] Rosenthal DA, Russell J, Thomson G. The health and wellbeing of international students at an Australian university. High Educ 2008; 55 51
| The health and wellbeing of international students at an Australian university.Crossref | GoogleScholarGoogle Scholar |
[9] Skromanis S, Cooling N, Rodgers B, Purton T, Fan F, Bridgman H, et al Health and well-being of international university students, and comparison with domestic students, in Tasmania, Australia. Int J Environ Res Public Health 2018; 15 1147
| Health and well-being of international university students, and comparison with domestic students, in Tasmania, Australia.Crossref | GoogleScholarGoogle Scholar |
[10] Ryan R, Dowler B, Bruce S, Gamage S, Morris A. The wellbeing of international students in the city of Sydney. Sydney: University of Technology Sydney, Institute for Public Policy and Governance; 2016. Available online at: https://www.uts.edu.au/sites/default/files/Research+into+the+Wellbeing+of+International+Students+in+the+City+of+Sydney_Final_27+July+2016.pdf [verified 18 March 2019].
[11] Vivancos R, Abubakar I, Hunter PR. Sexual behaviour, drugs and alcohol use of international students at a British university: a cross-sectional survey. Int J STD AIDS 2009; 20 619–22.
| Sexual behaviour, drugs and alcohol use of international students at a British university: a cross-sectional survey.Crossref | GoogleScholarGoogle Scholar | 19710334PubMed |
[12] Fallon F, Barbara D. Are our international students using the health system effectively? Proceedings of the 16th ISANA International Education Conference; 29 November–2 December 2005; Christchurch, New Zealand. Christchurch; ISANA International Education Association Inc.; 2005. Available online at: http://isana.proceedings.com.au/docs/2005/papers%20(pdf)/wed_1045_fallon.pdf [verified 7 March 2019].
[13] Department of Home Affairs. Subclass 500: Student Visa. Canberra: Australian Government; 2019. Available online at: https://immi.homeaffairs.gov.au/visas/getting-a-visa/visa-listing/student-500 [verified 5 March 2019].
[14] Song A, Richters J, Crawford J, Kippax S. HIV and sexual health knowledge and sexual experience among Australian-born and overseas-born students in Sydney. Journal of Adolescent Health 2005; 37 243.e9–.e14.
| HIV and sexual health knowledge and sexual experience among Australian-born and overseas-born students in Sydney.Crossref | GoogleScholarGoogle Scholar |
[15] Simpson S, Clifford C, Ross K, Sefton N, Owen L, Blizzard L, et al Sexual health literacy of the student population of the University of Tasmania: results of the RUSSL Study. Sex Health 2015; 12 207–16.
| Sexual health literacy of the student population of the University of Tasmania: results of the RUSSL Study.Crossref | GoogleScholarGoogle Scholar | 25928047PubMed |
[16] Ewert C, Collyer A, Temple-Smith M. ‘Most young men think you have to be naked in front of the GP’: a qualitative study of male university students’ views on barriers to sexual health. Sex Health 2016; 13 124–30.
| ‘Most young men think you have to be naked in front of the GP’: a qualitative study of male university students’ views on barriers to sexual health.Crossref | GoogleScholarGoogle Scholar | 26691872PubMed |
[17] Burchard A, Laurence C, Stocks N. Female international students and sexual health: a qualitative study into knowledge, beliefs and attitudes. Aust Fam Physician 2011; 40 817–20.
| 22003488PubMed |
[18] Baek Y, Akbar H, Baguley G. Relationships and sexual health promotion project for QUT international students. Proceedings of the 23rd ISANA International Academy Association Conference; 4–7 December 2012; Auckland, New Zealand. Hobart: ISANA International Education Association Inc.; 2012. Available online at: http://isana.proceedings.com.au/docs/2012/isana2012Final00043.pdf [verified 7 March 2019].
[19] Anderson A, Kitsos J, Miller A, Abraham S. A qualitative study of health care experiences among international students. Health Care Manag (Frederick) 2017; 36 78–86.
| A qualitative study of health care experiences among international students.Crossref | GoogleScholarGoogle Scholar | 28027196PubMed |
[20] Martin S, Dyer J. Health maintenance practices and healthcare experiences among international university students. J Am Assoc Nurse Pract 2017; 29 651–7.
| 29024562PubMed |
[21] Medland N. Australia will never be HIV-free if access to prevention requires a Medicare card. UNSW Sydney Newsroom, 24 January 2019. Available online at: https://newsroom.unsw.edu.au/news/health/australia-will-never-be-hiv-free-if-access-prevention-requires-medicare-card [verified 3 September 2019].
[22] Ending HIV. MI-EPIC Study. Sydney: ACON; 2019. Available online at: https://endinghiv.org.au/stay-safe/epic-nsw/ [verified 5 September 2019].
[23] Medland NA, Chow EPF, Read THR, Ong JJ, Chen M, Denham I, et al Incident HIV infection has fallen rapidly in men who have sex with men in Melbourne, Australia (2013–2017) but not in the newly-arrived Asian-born. BMC Infect Dis 2018; 18 410
| Incident HIV infection has fallen rapidly in men who have sex with men in Melbourne, Australia (2013–2017) but not in the newly-arrived Asian-born.Crossref | GoogleScholarGoogle Scholar | 30126355PubMed |
[24] Australian Human Rights Commission. Change the course: national report on sexual assault and sexual harassment at Australian universities (2017). Sydney: Australian Human Rights Commission; 2017. Available online at: https://www.humanrights.gov.au/our-work/sex-discrimination/publications/change-course-national-report-sexual-assault-and-sexual [verified 5 September 2019].
[25] Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3 77–101.
| Using thematic analysis in psychology.Crossref | GoogleScholarGoogle Scholar |
[26] Brunner Huber LR, Ersek JL. Contraceptive use among sexually active university students. J Women’s Health (Larchmt) 2009; 18 1063–70.
| Contraceptive use among sexually active university students.Crossref | GoogleScholarGoogle Scholar |
[27] Denison HJ, Bromhead C, Grainger R, Dennison EM, Jutel A. Barriers to sexually transmitted infection testing in New Zealand: a qualitative study. Aust N Z J Public Health 2017; 41 432–7.
| Barriers to sexually transmitted infection testing in New Zealand: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 28664644PubMed |
[28] Ferguson DH, Sherrell H. Overseas students in Australian higher education: a quick guide. Canberra: Parliament of Australia; 2019. Available online at: https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1819/Quick_Guides/OverseasStudents [verified 14 September 2019].