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Gray C, Crawford G, Roberts M, Vujcich D. 'You are making it sound like you are talking to a child': exploring community sentiment on developing and disseminating tailored sexual health education resources for migrants. HEALTH EDUCATION RESEARCH 2024; 39:444-453. [PMID: 38568929 DOI: 10.1093/her/cyae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/06/2024] [Accepted: 03/15/2024] [Indexed: 04/05/2024]
Abstract
Health communication is a critical component of public health, which includes health education resources. Resource effectiveness is improved where health literacy demands, including the cultural appropriateness of resources, match the intended audience. International guidelines support the tailoring of resources for migrants from culturally and linguistically diverse backgrounds (CaLD). Five focus groups (n = 18) and interviews (n = 9) with people from CaLD migrant backgrounds explored community perspectives on sexual health resources developed by a state department of health, specifically clarity, comprehensiveness, cultural appropriateness and strategies for dissemination. We identified three major thematic areas relating to simplicity, cultural norms and beliefs and dissemination. Participants recommended resource delivery in different formats as part of a broader intervention. Generally, sexual health information was deemed appropriate and easily understood. However, the resources used simplified language that participants reported was vague and inaccurate at times, potentially contributing to misinformation and reinforcing stigma relating both to the status of being a migrant and sexual health. Findings suggest the need for more nuanced health resource development beyond translation and language simplification. Resources developed in different formats, including different health literacy demands, using approaches that engage the target group in design and dissemination and contextualized within a comprehensive health promotion project, are likely to be more effective.
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Affiliation(s)
- Corie Gray
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Meagan Roberts
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Daniel Vujcich
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
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Mirzaei Damabi N, Begum M, Avery JC, Padhani ZA, Lassi ZS. Unveiling silenced narratives: a scoping review on sexual function challenges in migrant and refugee women. Sex Med Rev 2024; 12:288-298. [PMID: 38462747 DOI: 10.1093/sxmrev/qeae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Of the approximately 281 million international migrants and 35.3 million refugees around the world, almost half are women. These individuals experience significant stress due to language barriers, financial difficulties, poor living and working conditions, and discrimination. Consequently, concerns related to sexuality may receive lower priority despite their significant impact on overall well-being. OBJECTIVES This scoping review aims to review the sexual function of migrant and refugee women and identify any knowledge gaps in the field. METHODS We conducted a scoping review following the PRISMA-ScR guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews). We searched online databases-Medline, Embase, Emcare, PsycINFO, CINAHL, Scopus, Web of Science, and Cochrane-and gray literature, with no restrictions on year of publication, language, or study design. Utilizing Covidence software, 2 authors screened and extracted data from studies based on predetermined eligibility criteria. A thematic analysis was executed, and findings were reported descriptively. RESULTS Initially, we identified 5615 studies; after screening titles, abstracts, and full texts, we ultimately included 12 studies. The review identified a limited body of research with various unvalidated tools. Moreover, these studies yielded heterogeneous results: migrant women reported less sexual knowledge, experience, and liberal attitudes, resulting in lower rates of desire and arousal as compared with nonmigrants. Some studies showed lower sexual function in migrants, while others found no significant differences between migrants and nonmigrants. The assimilation into Western cultures may influence migrants' sexual attitudes and behaviors. Factors such as education and gender role ideology can also significantly affect sexual function among migrant populations. CONCLUSION This review underscores the limitations in previous sexual function research, emphasizing the need for a more inclusive approach. It also offers valuable insights for codesigning programs to address sexual dysfunction among migrant and refugee women, improving their well-being. Future research should prioritize neglected populations and create culturally sensitive interventions to reduce sexual health disparities in migrants.
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Affiliation(s)
- Negin Mirzaei Damabi
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Mumtaz Begum
- Life Course and Intergenerational Health Research Group, Faculty of Health and Medical Science, University of Adelaide, Adelaide 5005, Australia
| | - Jodie C Avery
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Zahra Ali Padhani
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Zohra S Lassi
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
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García-León A, Granero-Molina J, Jiménez-Lasserrotte MDM. Sub-Saharan Irregular Migrant Women's Sexuality: A Qualitative Study in Humanitarian Reception Centers. Healthcare (Basel) 2024; 12:1068. [PMID: 38891143 PMCID: PMC11172193 DOI: 10.3390/healthcare12111068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Irregular female migration to Europe is a growing phenomenon, as more and more women are fleeing their countries of origin due to gender inequality and violence. During the migration process, women experience physical, psychological and social problems that affect their sex lives. The aim of our study is to describe and understand how irregular migrant women living in humanitarian reception centers experience their sexuality at different stages of the migration process. This qualitative phenomenological study collected data through sixteen in-depth interviews with irregular migrant women between January and February 2023. Data analysis was carried out using ATLAS-ti 23.0 software, from which three themes were extracted: (1) The reality of sub-Saharan women's sexuality, (2) In search of a better life: the choice between taking the risk or surrendering, and (3) The sexual revolution among migrants. Sub-Saharan women's sexuality is subject to a complex normative order. The migratory process has severe consequences on migrant women's sex life. The sexual needs of irregular migrant women admitted to humanitarian reception centers undergo a process of change that must be understood by healthcare providers in order to make improvements to care provision.
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Affiliation(s)
- Alicia García-León
- Faculty of Health Sciences, University of Almería, 04120 Almería, Spain;
| | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain;
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 7500000, Chile
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Rossoni I, Chollier M, Dudushi R, Ghigo J, Padovese V. A scoping review of sexual and reproductive health recommendations in the context of migration to Europe. J Eur Acad Dermatol Venereol 2023; 37:2450-2461. [PMID: 37591613 DOI: 10.1111/jdv.19428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 07/21/2023] [Indexed: 08/19/2023]
Abstract
In recent years, growing instability and conflict around the world have continued to fuel outward migration, including migration to the EU/EEA. Many migrants hail from countries and regions with a higher burden of STIs-including HIV-and are exposed to enhanced risks of sexual and gender-based violence leading to sexual health issues during their journeys. This scoping review aims to identify existing sexual health recommendations for non-European migrants in the EU/EEA and identify gaps in their implementation. Sexual health recommendations formulated in relation to the migrant population in peer- reviewed journals or by expert consensus, between 2010 and 2021, were included. A keyword search was used to retrieve relevant publications on PubMed, ScienceDirect, the Cochrane Library databases, WHO and ECDC websites. The search strategy employed was charted in a dedicated Prisma Chart. Overall, 180 publications were retrieved. Based on the abstract and after eliminating duplicates, 33 publications were included for full-text reading. The references of these publications were screened. In total, 19 publications met the inclusion criteria. Evidence-based sexual health recommendations target only newly arrived migrants and migrant children (at arrival and during stay in the country). Screening practices are mostly informed by the country of origin and related prevalence, which remains a limitation; challenges faced during migration should also be considered. Implementation and compliance with these recommendations remain uncertain, as sexual health is not funded and addressed in a uniform manner across Europe.
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Affiliation(s)
- I Rossoni
- Van Vollenhoven Institute for Law, Governance and Society, Leiden University, Leiden, The Netherlands
| | - M Chollier
- CRIR-AVS PACA, APHM, Marseille, France
- UNESCO Chair for Sexual Health and Human Rights, Paris, France
| | - R Dudushi
- Faculty of Social Sciences, University of Tirana, Tirana, Albania
| | - J Ghigo
- Department of Obstetrics and Gynecology, Mater Dei Hospital, Msida, Malta
| | - V Padovese
- Genitourinary Clinic, Department of Dermatology and Venereology, Mater Dei Hospital, Msida, Malta
- International Foundation for Dermatology, Migrant Health Dermatology Working Group, London, UK
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Granero-Molina J, Gómez-Vinuesa AS, Granero-Heredia G, Fernández-Férez A, Ruiz-Fernández MD, Fernández-Medina IM, Jiménez-Lasserrotte MDM. Sexual and Reproductive Health Care for Irregular Migrant Women: A Meta-Synthesis of Qualitative Data. Healthcare (Basel) 2023; 11:healthcare11111659. [PMID: 37297799 DOI: 10.3390/healthcare11111659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023] Open
Abstract
Migratory movements are a political, social, and public health issue on a global scale. Access to sexual and reproductive health services for irregular migrant women (IMW) is a public health issue. The aim of this study is to identify qualitative evidence of IMW's experiences of sexual and reproductive health care in emergency and primary care settings. The methods employed involve conducting a meta-synthesis of qualitative studies. Synthesis includes assembling and categorising findings based on similarity in meaning. The search was conducted between January 2010 and June 2022 using PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases. Out of the initial pool of 142 articles identified, only 9 fulfilled the predetermined criteria and were subsequently included in the review. Four main themes were established: (1) the need to focus emergency care on sexual and reproductive health; (2) unsatisfactory clinical experiences; (3) forced reproduction; and (4) alternating between formal and informal healthcare services. The attitudes of IMW towards sexual and reproductive health are influenced by culture, educational level, fear, barriers, and the attitude of healthcare providers. Healthcare institutions need to be aware of the IMW's experiences to understand the specific difficulties they face. IMW calls for socially and culturally sensitive health care, cultural mediators, improved communication, and safe environments that ensure confidentiality.
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Affiliation(s)
- José Granero-Molina
- Nursing, Phisiotheraphy and Medicine Department, University of Almería, 04120 Almería, Spain
- Associate Researcher, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago 7500000, Chile
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Van Landeghem E, Dielen S, Semaan A, Rotsaert A, Vanhamel J, Masquillier C, Wouters E, Wouters K, Vuylsteke B, Reyniers T, Nöstlinger C. Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium. BMC Public Health 2023; 23:712. [PMID: 37076823 PMCID: PMC10113984 DOI: 10.1186/s12889-023-15540-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/27/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND PrEP uptake is low among non-Belgian men and transwomen who have sex with men, although the HIV epidemic among men who have sex with men in Belgium is diversifying in terms of nationalities and ethnicity. We lack an in-depth understanding of this gap. METHODS We conducted a qualitative study using a grounded theory approach. The data consists of key informants interviews and in-depth interviews with migrant men or transwomen who have sex with men. RESULTS We identified four underlying determinants which shape our participants' experiences and contextualize the barriers to PrEP use. These include (1) the intersectional identities of being migrant and men and transwomen who have sex with men, (2) migration related stressors, (3) mental health and (4) socio-economic vulnerability. Identified barriers include: the accessibility of services; availability of information, social resources and providers' attitudes. These barriers influence PrEP acceptance and mediated by individual agency this influences their PrEP uptake. CONCLUSION An interplay of several underlying determinants and barriers impacts on PrEP uptake among migrant men and transwomen who have sex with men, illustrating a social gradient in access to PrEP. We need equitable access to the full spectrum of HIV prevention and care for all priority populations, including undocumented migrants. We recommend social and structural conditions that foster exercising these rights, including adapting PrEP service delivery, mental health and social support.
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Affiliation(s)
- Ella Van Landeghem
- Department of Public Health, Institute of Tropical Medicine Nationalestraat 155, 2000, Antwerp, Belgium.
| | - Stef Dielen
- Department of Public Health, Institute of Tropical Medicine Nationalestraat 155, 2000, Antwerp, Belgium
| | - Aline Semaan
- Department of Public Health, Institute of Tropical Medicine Nationalestraat 155, 2000, Antwerp, Belgium
| | - Anke Rotsaert
- Department of Public Health, Institute of Tropical Medicine Nationalestraat 155, 2000, Antwerp, Belgium
| | - Jef Vanhamel
- Department of Public Health, Institute of Tropical Medicine Nationalestraat 155, 2000, Antwerp, Belgium
| | | | - Edwin Wouters
- Department of Sociology, University of Antwerp, Antwerp, Belgium
| | - Kristien Wouters
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine Nationalestraat 155, 2000, Antwerp, Belgium
| | - Thijs Reyniers
- Department of Public Health, Institute of Tropical Medicine Nationalestraat 155, 2000, Antwerp, Belgium
| | - Christiana Nöstlinger
- Department of Public Health, Institute of Tropical Medicine Nationalestraat 155, 2000, Antwerp, Belgium
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De Schrijver L, Nobels A, Harb J, Nisen L, Roelens K, Vander Beken T, Vandeviver C, Keygnaert I. Victimization of Applicants for International Protection Residing in Belgium: Sexual Violence and Help-Seeking Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12889. [PMID: 36232187 PMCID: PMC9566446 DOI: 10.3390/ijerph191912889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sexual violence (SV) literature on applicants for international protection (AIPs) shows that they are at high risk of victimization. The study objectives are to provide an exploratory overview of the occurrence of SV in AIPs in Belgium and their help-seeking behavior (HSB). This overview is crucial to develop prevention strategies and care paths focusing on providing adequate care to AIP SV victims in Belgium. METHODS Quantitative data from structured interviews with AIPs (n = 62) triangulated with qualitative data from in-depth interviews with AIP SV victims (n = 11) served to explore the nature and impact of SV in AIPs in Belgium and their HSB. RESULTS A total of 83.9% of respondents have experienced SV. A total of 61.3% were victimized within the past year. Victimization seems more gender-balanced than in the general population. AIPs link SV to their legal status and their associated vulnerable situation. HSB upon SV was very limited in this sample. Help-seeking barriers interfering with the decision-making process to consult (in)formal resources were identified. CONCLUSIONS AIPs in Belgium are at high risk of SV. Despite the impact of SV on AIPs' lives, HSB upon SV is rare. The provision of age-appropriate sexual education and development of policies that will reduce help-seeking barriers is needed.
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Affiliation(s)
- Lotte De Schrijver
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Anne Nobels
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
- Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jonathan Harb
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Laurent Nisen
- CARE-ESPRIst, Études et Évaluations, University of Liège, 4000 Liège, Belgium
| | - Kristien Roelens
- Department of Obstetrics and Gynecology, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium
| | - Tom Vander Beken
- Department of Criminology, Criminal Law and Social Law, Institute for International Research on Criminal Policy, Ghent University, 9000 Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Institute for International Research on Criminal Policy, Ghent University, 9000 Ghent, Belgium
- Research Foundation—Flanders (FWO), 1000 Brussels, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
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Fakhoury J, Burton-Jeangros C, Consoli L, Duvoisin A, Jackson Y. Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel Study. Front Public Health 2022; 10:832090. [PMID: 35664122 PMCID: PMC9160788 DOI: 10.3389/fpubh.2022.832090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/11/2022] [Indexed: 11/24/2022] Open
Abstract
Background Switzerland has a universal healthcare system. Yet, undocumented migrants face barriers at different levels that hinder their access to healthcare services. The aim of this study is to assess whether undocumented migrants' healthcare utilization improves with residence status regularization. Methods We used two-wave panel data from the Parchemins study, a study exploring the impact of regularization on undocumented migrants' health in Geneva, Switzerland. First wave data were collected between 2017 and 2018, second wave data between 2019 and 2020. At baseline, the sample consisted of 309 undocumented migrants, recruited after the implementation of a temporary regularization policy in Geneva. We distributed them into two groups according to their residence status 12 months before the second data collection [regularized vs. undocumented (controls)]. Using as dependent variable the number of medical consultations within two distinct 12-months periods (the first before regularization, the second after regularization), we conducted multivariable regression analyses applying hurdle specification to identify factors enhancing healthcare utilization. Then, we estimated first-difference panel models to assess change in healthcare utilization along regularization. Models were adjusted for demographic, economic and health-related factors. Results Of the 309 participants, 68 (22%) were regularized. For the 12 months before regularization, these migrants did not significantly differ in their healthcare utilization from the controls. At this stage, factors increasing the odds of having consulted at least once included being a female (aOR: 2.70; 95% CI: 1.37–5.30) and having access to a general practitioner (aOR: 3.15; 95% CI: 1.62–6.13). The factors associated with the number of consultations apart from underlying health conditions were the equivalent disposable income (aIRR per additional CHF 100.-: 0.98; 95% CI: 0.97–1.00) and having access to a general practitioner (aIRR: 1.45; 95% CI: 1.09–1.92). For the 12 months after regularization, being regularized was not associated with higher odds of having consulted at least once. However, among participants who consulted at least once, regularized ones reported higher counts of medical consultations than controls (3.7 vs. 2.6, p = 0.02), suggesting a positive impact of regularization. Results from the first-difference panel models confirmed that residence status regularization might have driven migrants' healthcare utilization (aβ: 0.90; 95% CI: 0.31-1.77). Conclusions This study supports the hypothesis that residence status regularization is associated with improved healthcare utilization among undocumented migrants. Future research is needed to understand the mechanisms through which regularization improves undocumented migrants' use of healthcare services.
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Affiliation(s)
- Julien Fakhoury
- Swiss National Center of Competence in Research (NCCR) “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland
- *Correspondence: Julien Fakhoury
| | - Claudine Burton-Jeangros
- Swiss National Center of Competence in Research (NCCR) “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland
| | - Liala Consoli
- Swiss National Center of Competence in Research (NCCR) “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland
| | - Aline Duvoisin
- Swiss National Center of Competence in Research (NCCR) “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Yves Jackson
- Geneva University Hospital and University of Geneva, Geneva, Switzerland
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Ahmadinia H, Eriksson-Backa K, Nikou S. Health information seeking behaviour during exceptional times: A case study of Persian-speaking minorities in Finland. LIBRARY & INFORMATION SCIENCE RESEARCH 2022. [DOI: 10.1016/j.lisr.2022.101156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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De Schrijver L, Fomenko E, Krahé B, Roelens K, Vander Beken T, Keygnaert I. Minority Identity, Othering-Based Stress, and Sexual Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4221. [PMID: 35409901 PMCID: PMC8998422 DOI: 10.3390/ijerph19074221] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Some (minority) groups (MGs) are more vulnerable to sexual violence (SV) exposure than others. Othering-based stress (OBS) may mediate the relationship between minority identification and SV. This study aims to assess the prevalence of SV in different MGs to explore the relationship between minority identification and SV, to investigate whether belonging to multiple MGs moderates this relationship, and to explore OBS SV moderation for different MGs. METHOD Through an online survey administered to a nationally representative sample in Belgium, data was collected from 4632 persons, of whom 21.01% self-identified as belonging to a MG (SI-Minority). SV prevalence was measured using behaviorally specific questions based on the WHO definition of SV. SI-Minority participants received an additional scale on OBS. RESULTS SI-Minority participants reported more SV victimization compared to the non-minorities. However, this increased risk was not moderated by minority identification but linked to the socio-demographic SV risk markers common to minority individuals. Multiple-minority participants were found more at risk of SV compared to single-minority respondents. Lesbian, gay, bisexual, pan-/omnisexual, asexual, and other non-heterosexual (LGB+) participants were found more at risk than heterosexual participants. OBS was found to be significantly correlated to SV in sexual and gender minorities and in cultural minorities. CONCLUSIONS This study contributes to our understanding of the relationship between minority identification, OBS, and SV. Studying both specific and common SV vulnerabilities and outcomes within specific societal subgroups and the general population may inform policy makers when allocating resources to those interventions with the largest societal impact.
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Affiliation(s)
- Lotte De Schrijver
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (E.F.); (I.K.)
| | - Elizaveta Fomenko
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (E.F.); (I.K.)
| | - Barbara Krahé
- Department of Psychology, University of Potsdam, 14476 Potsdam, Germany;
| | - Kristien Roelens
- Department of Obstetrics & Gynaecology, Ghent University Hospital, 9000 Ghent, Belgium;
- Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium
| | - Tom Vander Beken
- Department of Criminology, Criminal Law and Social Law, Institute for International Research on Criminal Policy, Ghent University, 9000 Ghent, Belgium;
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (E.F.); (I.K.)
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Baroudi M, Hurtig AK, Goicolea I, San Sebastian M, Jonzon R, Nkulu-Kalengayi FK. Young migrants' sexual rights in Sweden: a cross-sectional study. BMC Public Health 2021; 21:1618. [PMID: 34482819 PMCID: PMC8420038 DOI: 10.1186/s12889-021-11672-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background In national public health surveys including those assessing sexual and reproductive health, migrants generally tend to be underrepresented due to cultural, linguistic, structural and legal barriers, minimising the possibility to measure sexual rights’ fulfilment in this group. This study aims to describe to what extent sexual rights of young migrants in Sweden are being fulfilled. Methods A self-administered questionnaire was used to collect data from 1773 young (16–29 years) migrants by post, online, and at language schools and other venues. Sexual rights were operationalised and categorised into five domains adapted from the Guttmacher-Lancet Commission’s definition. These domains included the right to: 1) access sexual and reproductive healthcare, 2) access information and education about sexuality and sexual and reproductive health and rights, 3) have bodily integrity, 4) make free informed decisions about sexuality and sexual relations and 5) have a satisfying and safe sexual life. Descriptive analysis was used to assess the extent of fulfilment for each right. Results There were wide variations in the fulfilment of sexual rights between subgroups and among the five domains. Most respondents rated their sexual health as good/fair, however, 6.3% rated their sexual health as bad/very bad. While most of those who visited related services were satisfied, 17.4% of respondents refrained from visiting the services despite their needs. Around four in ten respondents did not know where to get information about sexuality and sexual health. One-fourth of respondents reported sexual violence. Another 12.7% were limited by family members or fellow countrymen regarding with whom they can have an intimate relationship. Most respondents were satisfied with their sexual life, except for 11.9%. Men, non-binary respondents, lesbians, gays, bisexuals, asexuals, those who were awaiting a decision regarding residence permit and those born in South Asia reported poor sexual health to a greater extent and fulfilment of their sexual rights to a lesser extent than other groups. Conclusions Timely and culturally adapted information about sexual rights, gender equalities, laws and available services in Sweden should be provided in appropriate languages and formats in order to raise awareness about sexual rights and improve access to available services. Tailored attention should be paid to specific vulnerable subgroups. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11672-1.
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Affiliation(s)
- Mazen Baroudi
- Department of Epidemiology and Global Health, Umeå University, Försörjningsvägen 7D, SE-907 37, Umeå, Sweden.
| | - Anna-Karin Hurtig
- Department of Epidemiology and Global Health, Umeå University, Försörjningsvägen 7D, SE-907 37, Umeå, Sweden
| | - Isabel Goicolea
- Department of Epidemiology and Global Health, Umeå University, Försörjningsvägen 7D, SE-907 37, Umeå, Sweden
| | - Miguel San Sebastian
- Department of Epidemiology and Global Health, Umeå University, Försörjningsvägen 7D, SE-907 37, Umeå, Sweden
| | - Robert Jonzon
- Department of Epidemiology and Global Health, Umeå University, Försörjningsvägen 7D, SE-907 37, Umeå, Sweden.,The Public Health Agency of Sweden, Nobels väg 18, SE-171 82, Solna, Sweden
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12
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Joarder T, Sutradhar I, Hasan MI, Bulbul MMI. A Record Review on the Health Status of Rohingya Refugees in Bangladesh. Cureus 2020; 12:e9753. [PMID: 32944468 PMCID: PMC7489778 DOI: 10.7759/cureus.9753] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The Rohingya refugee crisis is neither new nor a sudden problem for Bangladesh. However, the recent violence in August 2017 instigated the migration of 6,93,000 additional Rohingyas into Bangladesh and as of June 2018, around one million Rohingya refugees were residing in Bangladesh. Against this backdrop, it is important to know their current health status because, without this information, equal and equitable health service provision is not possible. So, we conducted this review to understand the current health status of the Rohingya refugees in Bangladesh. For this purpose, a systematic literature search was conducted in July 2018 using transparent selection criteria and the keywords "Rohingya", "Health", Bangladesh". After screening the title and abstract and removing duplication, 12 articles and 21 organizational reports were found eligible for final review. Major health problems prevailing among Rohingya refugees are unexplained fever, acute respiratory infection, and diarrhea. Non-communicable diseases like hypertension, diabetes, and their risk factors are also highly prevalent among these people. More than half of the Rohingya refugees are women and many of them experience sexual abuse or exploitation. More than 50,000 Rohingya refugee women were pregnant, however, a significant portion of pregnant women did not have access to quality antenatal care. Mental health problems like post-traumatic stress disorder (PTSD), depression, and suicidal thoughts were also commonly prevailing in the Rohingya community.
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Affiliation(s)
| | - Ipsita Sutradhar
- Epidemiology and Public Health, BRAC James P Grant School of Public Health, BRAC University, Dhaka, BGD
| | - Md Imran Hasan
- National Consultant, Institute of Public Health Nutrition, Dhaka, BGD
| | - Md Mafizul I Bulbul
- Ministry of Health and Family Welfare, National Nutrition Services, Dhaka, BGD
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13
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Lenderts JL, Hoffman SJ, Stitch J. The Role of Culture in Shaping Health Perceptions and Behaviors of Resettled Karen Refugees. J Transcult Nurs 2020; 32:145-152. [PMID: 32037976 DOI: 10.1177/1043659620902836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: While the many health vulnerabilities and challenges experienced by refugees have been previously documented, few studies have addressed the strengths-focused response strategies that women refugees, in particular, engage to navigate health systems and experiences associated with displacement. Our study attempts to document this among members of one group, the Karen, who represent a significant proportion of refugees resettled in the United States over the past decade. The purpose of this study was to explore how a sample of resettled Karen refugee women construct meaning around health, particularly in the context of cultural values, community, and migration. Methodology: This research took place in a series of ethnographic case studies documenting experiences of resilience, identity construction, and mothering among Karen refugee women from Burma. Data were collected through participant interviews with 12 Karen refugee women living in the United States. Interviews were transcribed, coded, and analyzed to identify themes relating to culturally influenced and newly emerging perceptions of health, identity, motherhood, and migration. Results: Participants identified correlates of doing, such as the ability to work and physical energy, as positively related to health, while the inability to do things was negatively related to health. Personal health also encompassed the health of family and community. Discussion: Women in this sample drew on broad, culturally informed ways of being to explain their health experiences. Implications of these findings are presented regarding how organizations and health providers can approach their work with refugees in culturally informed and relevant ways.
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Affiliation(s)
| | - Sarah J Hoffman
- University of Minnesota School of Nursing, Minneapolis, MN, USA
| | - Jaci Stitch
- University of Minnesota School of Nursing, Minneapolis, MN, USA
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14
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Royer PA, Olson LM, Jackson B, Weber LS, Gawron L, Sanders JN, Turok DK. "In Africa, There Was No Family Planning. Every Year You Just Give Birth": Family Planning Knowledge, Attitudes, and Practices Among Somali and Congolese Refugee Women After Resettlement to the United States. QUALITATIVE HEALTH RESEARCH 2020; 30:391-408. [PMID: 31347453 PMCID: PMC7219277 DOI: 10.1177/1049732319861381] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
It is crucial for refugee service providers to understand the family planning knowledge, attitudes, and practices of refugee women following third country resettlement. Using an ethnographic approach rooted in Reproductive Justice, we conducted six focus groups that included 66 resettled Somali and Congolese women in a western United States (US) metropolitan area. We analyzed data using modified grounded theory. Three themes emerged within the family planning domain: (a) concepts of family, (b) fertility management, and (c) unintended pregnancy. We contextualized these themes within existing frameworks for refugee cultural transition under the analytic paradigms of "pronatalism and stable versus evolving family structure" and "active versus passive engagement with family planning." Provision of just and equitable family planning care to resettled refugee women requires understanding cultural relativism, social determinants of health, and how lived experiences influence family planning conceptualization. We suggest a counseling approach and provider practice recommendations based on our study findings.
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Affiliation(s)
| | | | | | | | - Lori Gawron
- University of Utah, Salt Lake City, Utah, USA
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15
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Vaghri Z, Tessier Z, Whalen C. Refugee and Asylum-Seeking Children: Interrupted Child Development and Unfulfilled Child Rights. CHILDREN (BASEL, SWITZERLAND) 2019; 6:E120. [PMID: 31671545 PMCID: PMC6915556 DOI: 10.3390/children6110120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/12/2019] [Accepted: 10/24/2019] [Indexed: 11/17/2022]
Abstract
The 21st century phenomenon of "global displacement" is particularly concerning when it comes to children. Childhood is a critical period of accelerated growth and development. These processes can be negatively affected by the many stressors to which refugee and asylum-seeking children are subjected. The United Nations Convention on the Rights of the Child (CRC) is the most ratified human rights treaty in history, with 196 States Parties (SPs). The CRC provides a framework of 54 articles outlining government responsibilities to ensure the protection, promotion, and fulfillment of rights of all children within their jurisdictions. Among these are the rights of refugee and asylum-seeking children, declared under Article 22 of the CRC. Refugee and asylum-seeking children, similarly to all other children, are entitled to their rights under the CRC and do not forgo any right by virtue of moving between borders. The hosting governments, as SPs to the CRC, are the primary duty bearers to fulfill these rights for the children entering their country. This manuscript provides an overview of the health and developmental ramification of being displaced for refugee and asylum-seeking children. Then, an in-depth analysis of the provisions under Article 22 is presented and the responsibilities of SPs under this article are described. The paper provides some international examples of strengths and shortcomings relating to these responsibilities and closes with a few concluding remarks and recommendations.
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Affiliation(s)
- Ziba Vaghri
- School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, Victoria, BC V8P 5C2, Canada.
| | - Zoë Tessier
- School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, Victoria, BC V8P 5C2, Canada.
| | - Christian Whalen
- Office of Child and Youth Advocate, Fredericton, NB E3B 5H1, Canada.
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16
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Hawkey AJ, Ussher JM, Perz J. Regulation and Resistance: Negotiation of Premarital Sexuality in the Context of Migrant and Refugee Women. JOURNAL OF SEX RESEARCH 2018; 55:1116-1133. [PMID: 28682121 DOI: 10.1080/00224499.2017.1336745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Constructions of normative sexuality shape the sexual scripts that women are permitted to adopt and the manner in which such sexuality can be expressed. We explored experiences and constructions of premarital sexuality among migrant and refugee women recently resettled in Sydney, Australia, and Vancouver, Canada. A total of 78 semistructured individual interviews and 15 focus groups composed of 82 participants were undertaken with women who had migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. We analyzed the data using thematic decomposition. Across all cultural groups, women's premarital sexuality was regulated through cultural and religious discourse and material practice. Such regulation occurred across three main facets of women's lives, shaping the themes presented in this article: (1) regulating premarital sex-the virginity imperative; (2) regulation of relationships with men; and (3) regulation of the sexual body. These themes capture women's reproduction of dominant discourses of premarital sexuality, as well as women's resistance and negotiation of such discourses, both prior to and following migration. Identifying migrant and refugee women's experiences and constructions of premarital sexuality is essential for culturally safe sexual health practice, health promotion, and health education.
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Affiliation(s)
- Alexandra J Hawkey
- a Translational Research Institute (THRI), School of Medicine, Western Sydney University
| | - Jane M Ussher
- a Translational Research Institute (THRI), School of Medicine, Western Sydney University
| | - Janette Perz
- a Translational Research Institute (THRI), School of Medicine, Western Sydney University
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17
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Raben LAD, van den Muijsenbergh METC. Inequity in contraceptive care between refugees and other migrant women?: a retrospective study in Dutch general practice. Fam Pract 2018; 35:468-474. [PMID: 29351609 DOI: 10.1093/fampra/cmx133] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Female refugees are at high risk of reproductive health problems including unmet contraceptive needs. In the Netherlands, the general practitioner (GP) is the main entrance to the healthcare system and plays a vital role in the prescription of contraceptives. Little is known about contraceptive care in female refugees in primary care. OBJECTIVE To get insight into GP care related to contraception in refugees and other migrants compared with native Dutch women. METHODS A retrospective descriptive study of patient records of refugees, other migrants and native Dutch women was carried out in five general practices in the Netherlands. The prevalence of discussions about contraception and prescriptions of contraceptives over the past 6 years was compared in women of reproductive age (15-49 years). RESULTS In total, 104 refugees, 58 other migrants and 162 native Dutch women were included. GPs in our study (2 male, 3 female) discussed contraceptives significantly less often with refugees (51%) and other migrants (66%) than with native Dutch women (84%; P < 0.001 and P = 0.004, respectively). Contraceptives were less often prescribed to refugees (34%) and other migrants (55%) than to native Dutch women (79%; P < 0.001 and P = 0.001). Among refugees from Sub-Saharan Africa, contraception was significantly less often discussed (28.9%) compared with refugees from other regions (67.8%; P < 0.001). More refugees and other migrants had experienced unwanted pregnancies (14% respectively 9%) and induced abortions (12% respectively 7%) than native Dutch women (4% respectively 4%). CONCLUSION Contraceptives were significantly less often discussed with and prescribed to refugees and other migrant women compared with native Dutch women. More research is needed to elicit the reproductive health needs and preferences of migrant women regarding GP's care and experiences in discussing these issues. Such insights are vital in order to provide equitable reproductive healthcare to every woman regardless of her background.
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Affiliation(s)
- Liselotte A D Raben
- Department of Primary and Community Care, Radboud University Medical Centren, Nijmegen, the Netherlands
| | - Maria E T C van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Centren, Nijmegen, the Netherlands.,Pharos, Centre of Expertise on Health Disparities, Utrecht, the Netherlands
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18
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"In My Culture, We Don't Know Anything About That": Sexual and Reproductive Health of Migrant and Refugee Women. Int J Behav Med 2018. [PMID: 28620774 DOI: 10.1007/s12529-017-9662-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Migrant and refugee women are at risk of negative sexual and reproductive health (SRH) outcomes due to low utilisation of SRH services. SRH is shaped by socio-cultural factors which can act as barriers to knowledge and influence access to healthcare. Research is needed to examine constructions and experiences of SRH in non-English-speaking migrant and refugee women, across a range of cultural groups. METHOD This qualitative study examined the constructions and experiences of SRH among recent migrant and refugee women living in Sydney, Australia, and Vancouver, Canada. A total of 169 women from Afghanistan, Iraq, Somalia, South Sudan, Sudan, India, Sri Lanka and South America participated in the study, through 84 individual interviews, and 16 focus groups comprised of 85 participants. Thematic analysis was used to analyse the data. RESULTS Three themes were identified: "women's assessments of inadequate knowledge of sexual and reproductive health and preventative screening practices", "barriers to sexual and reproductive health" and "negative sexual and reproductive health outcomes". Across all cultural groups, many women had inadequate knowledge of SRH, due to taboos associated with constructions and experiences of menstruation and sexuality. This has implications for migrant and refugee women's ability to access SRH education and information, including contraception, and sexual health screening, making them vulnerable to SRH difficulties, such as sexually transmissible infections and unplanned pregnancies. CONCLUSION It is essential for researchers and health service providers to understand socio-cultural constraints which may impede SRH knowledge and behaviour of recent migrant and refugee women, in order to provide culturally safe SRH education and services that are accessible to all women at resettlement irrespective of ethnicity or migration category.
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19
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Structural violence and marginalisation. The sexual and reproductive health experiences of separated young people on the move. A rapid review with relevance to the European humanitarian crisis. Public Health 2018; 158:156-162. [DOI: 10.1016/j.puhe.2018.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 03/05/2018] [Accepted: 03/07/2018] [Indexed: 01/13/2023]
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20
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Ussher JM, Perz J, Metusela C, Hawkey AJ, Morrow M, Narchal R, Estoesta J. Negotiating Discourses of Shame, Secrecy, and Silence: Migrant and Refugee Women's Experiences of Sexual Embodiment. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1901-1921. [PMID: 28083724 PMCID: PMC5547186 DOI: 10.1007/s10508-016-0898-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/27/2016] [Accepted: 10/31/2016] [Indexed: 05/12/2023]
Abstract
In Australia and Canada, the sexual health needs of migrant and refugee women have been of increasing concern, because of their underutilization of sexual health services and higher rate of sexual health problems. Previous research on migrant women's sexual health has focused on their higher risk of difficulties, or barriers to service use, rather than their construction or understanding of sexuality and sexual health, which may influence service use and outcomes. Further, few studies of migrant and refugee women pay attention to the overlapping role of culture, gender, class, and ethnicity in women's understanding of sexual health. This qualitative study used an intersectional framework to explore experiences and constructions of sexual embodiment among 169 migrant and refugee women recently resettled in Sydney, Australia and Vancouver, Canada, from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, India, and South America, utilizing a combination of individual interviews and focus groups. Across all of the cultural groups, participants described a discourse of shame, associated with silence and secrecy, as the dominant cultural and religious construction of women's sexual embodiment. This was evident in constructions of menarche and menstruation, the embodied experience that signifies the transformation of a girl into a sexual woman; constructions of sexuality, including sexual knowledge and communication, premarital virginity, sexual pain, desire, and consent; and absence of agency in fertility control and sexual health. Women were not passive in relation to a discourse of sexual shame; a number demonstrated active resistance and negotiation in order to achieve a degree of sexual agency, yet also maintain cultural and religious identity. Identifying migrant and refugee women's experiences and constructions of sexual embodiment are essential for understanding sexual subjectivity, and provision of culturally safe sexual health information in order to improve well-being and facilitate sexual agency.
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Affiliation(s)
- Jane M Ussher
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
| | - Janette Perz
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Christine Metusela
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Alexandra J Hawkey
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Marina Morrow
- Centre for the Study of Gender, Social Inequities and Mental Health, Simon Fraser University, Vancouver, BC, Canada
| | - Renu Narchal
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Jane Estoesta
- , Family Planning New South Wales, Sydney, NSW, Australia
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21
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Ussher JM, Perz J, Metusela C, Hawkey AJ, Morrow M, Narchal R, Estoesta J. Negotiating Discourses of Shame, Secrecy, and Silence: Migrant and Refugee Women's Experiences of Sexual Embodiment. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1901-1921. [PMID: 28083724 DOI: 10.1007/s10508-10016-10898-10509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/27/2016] [Accepted: 10/31/2016] [Indexed: 05/26/2023]
Abstract
In Australia and Canada, the sexual health needs of migrant and refugee women have been of increasing concern, because of their underutilization of sexual health services and higher rate of sexual health problems. Previous research on migrant women's sexual health has focused on their higher risk of difficulties, or barriers to service use, rather than their construction or understanding of sexuality and sexual health, which may influence service use and outcomes. Further, few studies of migrant and refugee women pay attention to the overlapping role of culture, gender, class, and ethnicity in women's understanding of sexual health. This qualitative study used an intersectional framework to explore experiences and constructions of sexual embodiment among 169 migrant and refugee women recently resettled in Sydney, Australia and Vancouver, Canada, from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, India, and South America, utilizing a combination of individual interviews and focus groups. Across all of the cultural groups, participants described a discourse of shame, associated with silence and secrecy, as the dominant cultural and religious construction of women's sexual embodiment. This was evident in constructions of menarche and menstruation, the embodied experience that signifies the transformation of a girl into a sexual woman; constructions of sexuality, including sexual knowledge and communication, premarital virginity, sexual pain, desire, and consent; and absence of agency in fertility control and sexual health. Women were not passive in relation to a discourse of sexual shame; a number demonstrated active resistance and negotiation in order to achieve a degree of sexual agency, yet also maintain cultural and religious identity. Identifying migrant and refugee women's experiences and constructions of sexual embodiment are essential for understanding sexual subjectivity, and provision of culturally safe sexual health information in order to improve well-being and facilitate sexual agency.
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Affiliation(s)
- Jane M Ussher
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
| | - Janette Perz
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Christine Metusela
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Alexandra J Hawkey
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Marina Morrow
- Centre for the Study of Gender, Social Inequities and Mental Health, Simon Fraser University, Vancouver, BC, Canada
| | - Renu Narchal
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia
| | - Jane Estoesta
- , Family Planning New South Wales, Sydney, NSW, Australia
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22
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Giving voice to the voiceless: how to involve vulnerable migrants in healthcare research. Br J Gen Pract 2017; 66:284-5. [PMID: 27231286 DOI: 10.3399/bjgp16x685321] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Arrey AE, Bilsen J, Lacor P, Deschepper R. A qualitative study of the perspectives of Sub-Saharan African migrant women with HIV/AIDS and their caregivers on treatment and care in Belgium. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1236480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Agnes Ebotabe Arrey
- Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Patrick Lacor
- Department of Internal Medicine and Infectious Diseases, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Reginald Deschepper
- Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
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Hacker K, Anies M, Folb BL, Zallman L. Barriers to health care for undocumented immigrants: a literature review. Risk Manag Healthc Policy 2015; 8:175-83. [PMID: 26586971 PMCID: PMC4634824 DOI: 10.2147/rmhp.s70173] [Citation(s) in RCA: 280] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
With the unprecedented international migration seen in recent years, policies that limit health care access have become prevalent. Barriers to health care for undocumented immigrants go beyond policy and range from financial limitations, to discrimination and fear of deportation. This paper is aimed at reviewing the literature on barriers to health care for undocumented immigrants and identifying strategies that have or could be used to address these barriers. To address study questions, we conducted a literature review of published articles from the last 10 years in PubMed using three main concepts: immigrants, undocumented, and access to health care. The search yielded 341 articles of which 66 met study criteria. With regard to barriers, we identified barriers in the policy arena focused on issues related to law and policy including limitations to access and type of health care. These varied widely across countries but ultimately impacted the type and amount of health care any undocumented immigrant could receive. Within the health system, barriers included bureaucratic obstacles including paperwork and registration systems. The alternative care available (safety net) was generally limited and overwhelmed. Finally, there was evidence of widespread discriminatory practices within the health care system itself. The individual level focused on the immigrant’s fear of deportation, stigma, and lack of capital (both social and financial) to obtain services. Recommendations identified in the papers reviewed included advocating for policy change to increase access to health care for undocumented immigrants, providing novel insurance options, expanding safety net services, training providers to better care for immigrant populations, and educating undocumented immigrants on navigating the system. There are numerous barriers to health care for undocumented immigrants. These vary by country and frequently change. Despite concerns that access to health care attracts immigrants, data demonstrates that people generally do not migrate to obtain health care. Solutions are needed that provide for noncitizens’ health care.
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Affiliation(s)
- Karen Hacker
- Allegheny County Health Department, Pittsburgh, PA, USA ; Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria Anies
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Barbara L Folb
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA ; Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA, USA
| | - Leah Zallman
- Institute for Community Health, Cambridge, MA, USA ; Cambridge Health Alliance, Cambridge, MA, USA ; Harvard School of Medicine, Boston, MA, USA
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