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REVIEW

A systematic review of international students’ sexual health knowledge, behaviours, and attitudes

Madeleine S. Y. Lim https://orcid.org/0000-0002-6112-6710 A * , Jane S. Hocking https://orcid.org/0000-0001-9329-8501 B , Lena Sanci https://orcid.org/0000-0003-4834-4737 A and Meredith Temple-Smith https://orcid.org/0000-0003-1296-9591 A
+ Author Affiliations
- Author Affiliations

A Department of General Practice, The University of Melbourne, 780 Elizabeth Street, Melbourne, Vic. 3004, Australia.

B Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia.

* Correspondence to: madeleine.lim@unimelb.edu.au

Handling Editor: Leo Wilton

Sexual Health 19(1) 1-16 https://doi.org/10.1071/SH21073
Submitted: 9 April 2021  Accepted: 1 July 2021   Published: 18 February 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

The demand for higher education has increased student mobility across the world. Studying abroad provides an opportunity for young adults to engage in sexual behaviours, some of which may be risky. Yet, little is known about international students’ current sexual health knowledge or practices. The aim of this review was to identify their sexual health knowledge, behaviours, and attitudes. A search of five databases yielded 21 studies that met inclusion criteria. These studies used quantitative (n = 13), qualitative (n = 7) and mixed methods (n = 1) and included a total of 4666 international and exchange students from diverse cultural backgrounds. Findings were grouped into three themes: sexual health knowledge, sexual behaviours, and sexual health attitudes. Asian international students had poorer levels of knowledge, suggesting a need for culturally appropriate sex education. They were less sexually experienced and were older than domestic students at first age of sex. Fewer engaged in risky sexual behaviours when compared to domestic students. They also reported fewer sexual partners and higher condom usage. However, culture influenced the sexual behaviours and attitudes of international students; in particular, Asian female international students, who tested risk-taking behaviours, such as casual sex, in more liberal Western countries. Appropriate intervention and further education are needed to decrease international students’ sexual health risks.

Keywords: Asian, culture, education, health risks, international students, risk behaviours, sexual health knowledge, STIs, studying abroad.


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