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Dhairyawan R, Shah A, Bailey J, Mohammed H. Factors associated with bacterial sexually transmitted infections among people of South Asian ethnicity in England. Sex Transm Infect 2024; 100:17-24. [PMID: 37932032 DOI: 10.1136/sextrans-2023-055879] [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: 05/26/2023] [Accepted: 10/08/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Despite being the largest ethnic minority group in England, South Asians have historically had low levels of utilisation of sexual health services (SHS) and sexually transmitted infection (STI) diagnoses, although recent data suggests this may be changing. This study aimed to investigate factors associated with a bacterial STI diagnosis among South Asians attending SHS in England. METHODS Using data from the GUMCAD STI Surveillance system, a descriptive analysis of South Asians attending SHS in England in 2019 was carried out. Factors associated with a bacterial STI diagnosis were examined using univariate and multivariable logistic regression models adjusted for age, Asian ethnic subgroup, HIV status, patient's region of residence and Index of Multiple Deprivation quintile. Analyses were stratified by gender and sexual orientation (heterosexual male versus gay, bisexual and other men who have sex with men (GBMSM) versus women of any sexual orientation). Crude and adjusted associations were derived using binary logistic regression. RESULTS There were 121 842 attendances by South Asians to SHS in England in 2019. Compared with heterosexual South Asian men, GBMSM had a higher odds of being diagnosed with a bacterial STI (adjusted odds ratio (aOR) 2.32, 95% CI 2.19 to 2.44) and South Asian women had a lower odds (aOR 0.83, 95% CI 0.78 to 0.87). For women and heterosexual South Asian men, a diagnosis was associated with younger age, being of any other Asian background other than Bangladeshi, Indian or Pakistani and not being HIV positive. For heterosexual South Asian men, there was an association with increasing socioeconomic deprivation. For GBMSM, a bacterial STI diagnosis was associated with known HIV-positive status and living in London. CONCLUSION People of South Asian ethnicity in England are heterogeneous with regard to their sexual health needs, which should be explored further through focused research and policy.
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Affiliation(s)
- Rageshri Dhairyawan
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
- SHARE Collaborative, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
| | - Ammi Shah
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Julia Bailey
- Primary Care and Population Health, University College London, London, UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
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Kiridaran V, Chawla M, Bailey JV. Views, attitudes and experiences of South Asian women concerning sexual health services in the UK: a qualitative study. EUR J CONTRACEP REPR 2022; 27:418-423. [PMID: 35899823 DOI: 10.1080/13625187.2022.2096216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To explore the views, attitudes, and experiences of South Asian women in the UK regarding sexual health services. METHODS We performed virtual semi-structured interviews with South Asian women 18 and over living in the UK. We explored participants' experiences of accessing sexual health services, including contraception, smear tests and sexually transmitted infection (STI) tests. We coded interview transcripts and analysed them thematically. RESULTS From February to April 2021, we conducted 14 interviews with South Asian women between the ages of 18 and 40 living in England and Wales, from February to April 2021. We identified four overarching themes: Access to sexual health services, entry to sexual health services, quality of sexual health services and stigma associated with sexual health services. Important barriers to sexual health services include limited knowledge of local provision, stigma and shame, and concerns about confidentiality. Participants found it difficult to discuss their sexual health (with anyone) and were often being met with judgement and a lack of partnership from clinicians. CONCLUSION Our results suggest that South Asian women are uncomfortable accessing sexual health services and communicating their sexual health concerns with health care professionals. Service providers should collaborate with community-based organisations to ensure that services are discrete, confidential, and culturally appropriate.
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Affiliation(s)
| | - Mehar Chawla
- Obstetrics & Gynaecology Department, West Middlesex University Hospital, Chelsea and Westminster NHS Trust, London, UK.,eHealth Unit, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Julia V Bailey
- eHealth Unit, Research Department of Primary Care and Population Health, University College London, London, UK
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Tyndall I, Hartland T, Banerjee M, Giacomelli V, Ball I, Churchill S, Pereira A, Lowry R. Tailoring Sexual Health Interventions for Middle-Aged and Older Adults, Including Vulnerable Populations: A Scoping Review. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:593-613. [PMID: 38596395 PMCID: PMC10903680 DOI: 10.1080/19317611.2022.2089313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 04/11/2024]
Abstract
Objective This scoping review aims to synthesize existing literature on good practice in sexual health interventions for adults over 45 years and in vulnerable groups. Methods Using PRISMA-ScR guidelines, search terms focused on sexual health, good practice, and vulnerable groups, in over-45s. Results Of the nine studies that met the inclusion criteria, seven were focused on HIV and risk reduction. Use of alternative methods of communication, alongside inclusion of behavioral and cognitive measures such as condom use and perceived stigma, was key to tailoring interventions. Conclusions This review highlights the imperative for further research on sexual health interventions with these overlooked populations.
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Affiliation(s)
- Ian Tyndall
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Tess Hartland
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Moitree Banerjee
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Victoria Giacomelli
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Isabelle Ball
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Susan Churchill
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Antonina Pereira
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Ruth Lowry
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
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Manjula V., Munivenkatappa M, Navaneetham J, Philip M. Quality of Marital Relationship and Sexual Interaction in Couples With Sexual Dysfunction: An Exploratory Study From India. JOURNAL OF PSYCHOSEXUAL HEALTH 2021. [DOI: 10.1177/26318318211047547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Sexual dysfunction and marital intimacy and quality are found to have a reciprocal relationship. Examining this relationship in couples seeking help for sexual dysfunctions in the cultural context of India is worthwhile. Aim: This study aims to explore the nature of sexual functioning, sexual interaction, sexual communication, and marital intimacy and quality in couples with sexual dysfunction. Further, relationship between the above variables is also examined. Methods: A cross-sectional, single-group exploratory design was adopted. A sample of 155 married heterosexual individuals, with a clinical diagnosis of sexual dysfunction in either of the spouses, was included in the study. The tools used included MINI neuropsychiatric interview, Marital Quality Scale, Marital Intimacy Questionnaire, Dyadic Sexual Communication Scale, and Sexual Interaction Inventory. Results: Erectile dysfunction and premature ejaculation in men and hypoactive sexual desire disorder in women were the most common sexual dysfunctions. Majority of the sample were young adults. About 82% of the sample had moderate-to-severe levels of marital distress. Mood disorder was the most common psychiatric disorder reported in the sample. High levels of intimacy problems were seen with no significant gender differences in the overall marital quality or intimacy. Difficulty in the overall sexual interactions was found; however, higher levels of dissatisfaction with the frequency of sex and lower self-acceptance was reported by men compared to women. Significant interrelationships were found between marital quality and intimacy, sexual interaction, and sexual communication. Conclusions: Sexual dysfunctions and marital distress are closely related. Sexual interaction and sexual communication play a significant role in marital quality and intimacy.
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Affiliation(s)
- Manjula V.
- Department of Psychology, Christ (deemed to be) University, Bangalore, Karnataka, India
| | - Manjula Munivenkatappa
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Janardhana Navaneetham
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Mariamma Philip
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Korri R, Hess S, Froeschl G, Ivanova O. Sexual and reproductive health of Syrian refugee adolescent girls: a qualitative study using focus group discussions in an urban setting in Lebanon. Reprod Health 2021; 18:130. [PMID: 34167553 PMCID: PMC8223310 DOI: 10.1186/s12978-021-01178-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/10/2021] [Indexed: 11/25/2022] Open
Abstract
Background The war in Syria caused the forced displacement of millions of Syrians to neighboring countries. Lebanon is the host country with the largest overall number of Syrian refugees per capita. Adolescent refugee girls experience a unique level of vulnerability during human emergencies and are at increased risk of suffering from poor sexual and reproductive health (SRH) outcomes. We conducted an exploratory qualitative study to learn about the SRH perceptions and experiences of refugee adolescent girls living in Bourj Hammoud, an urban setting in Lebanon. Methods We employed a qualitative design with eight focus group discussions (FGDs) conducted with 40 Syrian Arab and Syrian Kurdish adolescent girls between January and March 2020. Every FGD consisted of five participants aged 13 to 17 years. A semi-structured guide was used covering multiple themes: menstruation, puberty, SRH awareness, and sexual harassment. FGDs were transcribed and analyzed using thematic analysis. Findings The participants discussed adolescent girls’ health and named six elements of good health, such as healthy activities and self-protection. The majority of the FGD participants reported a lack of awareness about menstruation when they experienced it for the first time and the social stigma associated with menstruation. When defining puberty, they indicated its social link to a girl’s readiness for marriage and her need to become cautious about sexual harassment. Most FGD participants had very poor knowledge of the female reproductive system. Mothers were the most approached persons to receive information on SRH issues; however, the girls indicated a wish to receive advice from specialists in a comfortable and private atmosphere. All the girls reported that either they themselves, or an acquaintance, had experienced some type of sexual harassment. The girls rarely reported those incidents due to fear of being blamed or subjected to mobility restrictions, or forced to drop out of school. Conclusions The findings show the refugee girls need for satisfactory knowledge on SRH issues and interventions to prevent sexual and gender-based violence that take into consideration the complexity of urban settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01178-9. After almost 10 years of war, Syria’s neighboring countries are hosting millions of Syrians who were forcibly displaced. Most prominent among these countries is Lebanon. Adolescent refugee girls are exposed to precarious conditions, which make them more prone to sexual and reproductive health (SRH) problems. This qualitative study was performed in Bourj Hammoud, an urban setting in Lebanon, in order to explore Syrian refugee adolescent girls’ SRH perceptions and experiences. The agenda of the International Conference on Population and Development (ICPD) in addition to the Inter-Agency Field Manual on Reproductive Health in Humanitarian Settings (IAFM) and its Adolescent Sexual and Reproductive Health Toolkit for Humanitarian Settings issued by the Inter-Agency Working Group on Reproductive Health in Crises (IAWG) formed the framework of this study. Focus group discussions were performed with 40 Syrian Arab and Syrian Kurdish adolescent girls, each group consisting of five participants aged 13 to 17 years. Different themes were discussed within the groups including menstruation, puberty, and sexual harassment. The participants talked about the social stigma related to menstruation and the social link between puberty, a girl’s readiness for marriage, and her need to be careful about sexual harassment. Most of the girls had insufficient information about the female reproductive system. The girls consulted their mothers to learn about SRH issues; however, they expressed a wish to receive well-informed advice from specialists in a safe atmosphere. All the girls reported incidents of sexual harassment, which happened either to them or to other girls they know; however, they were discouraged to report them because they feared other consequences, such as being blamed or not being allowed to go to school anymore. The outcomes of the study show the girls’ urgent need to have adequate information about SRH issues and appropriate interventions to prevent sexual and gender-based violence within complex urban settings.
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Affiliation(s)
- Rayan Korri
- Munich Medical Research School (MMRS), Medical Faculty of the University of Munich (LMU), 80802, Munich, Germany.
| | - Sabine Hess
- Department of Cultural Anthropology/European Ethnology, University of Göttingen, 37073, Göttingen, Germany
| | - Guenter Froeschl
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802, Munich, Germany.,German Center for Infection Research (DZIF), Partner Site Munich, 80802, Munich, Germany
| | - Olena Ivanova
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), 80802, Munich, Germany.,German Center for Infection Research (DZIF), Partner Site Munich, 80802, Munich, Germany
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The need for service change and community outreach work to support trans-cultural cognitive behaviour therapy with Black and Minority Ethnic communities. COGNITIVE BEHAVIOUR THERAPIST 2019. [DOI: 10.1017/s1754470x18000016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractRecently there have been a number of developments in cognitive behaviour therapy (CBT) that have led to cultural adaptations of specific interventions and a greater awareness of how in general CBT might be adapted for Black and Minority Ethnic (BME) service users. These developments, however, involve change at the level of the individual therapist and particular treatment approach, but involve very few considerations of what needs to happen at the levels of teams or services in order to best meet the mental health needs of British South Asian and other BME populations. This paper summarizes the way that services need to understand how minority populations use services and how to involve those populations in developing services in order to ensure their needs are best met.
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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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"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: 78] [Impact Index Per Article: 13.0] [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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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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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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Majumdar A. IV. Researching South Asian Women's Experiences of Marriage: Resisting Stereotypes through an Exploration of `Space' and `Embodiment'. FEMINISM & PSYCHOLOGY 2016. [DOI: 10.1177/0959353507079085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wray A, Ussher JM, Perz J. Constructions and experiences of sexual health among young, heterosexual, unmarried Muslim women immigrants in Australia. CULTURE, HEALTH & SEXUALITY 2013; 16:76-89. [PMID: 24087911 DOI: 10.1080/13691058.2013.833651] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Minority ethnic immigrant women are frequently vulnerable to poor sexual health outcomes, due to poor use of sexual health services, lack of knowledge and social stigma associated with the discussion of sexuality. This paper explores the sexual health accounts provided by a group of young, unmarried heterosexual Muslim women immigrants residing and studying in Sydney, an under-researched group in the Australian context. Ten semi-structured interviews were conducted, focusing on sex before marriage, spouse selection and contraceptive use. Feminist discourse analysis identified 'purity versus corruption' as the primary construction of women's sexuality, where women positioned their sexual behaviour as that of purity and uninvolvement or corruption through unwedded participation. The subthemes 'maintaining ignorance and naivety', 'remaining virginal', 'sex segregation' and 'the fallen woman' capture women's personal sexuality-related experiences and values within the context of their religious and cultural communities. Additional research with this community is needed to examine the effects of negative social constructions of sex on young sexually active Muslim women, as well as further research on young women's sexual health within immigrant communities.
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Affiliation(s)
- Anneke Wray
- a Centre for Health Research, School of Medicine, University of Western Sydney , Sydney , Australia
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Abstract
OBJECTIVES This paper explores the nature of HIV-related stigma among South Asians in Toronto, its consequences for people living with it and its role in determining access to HIV services. DESIGN The study is based on data from four focus group discussions with members of an HIV outreach organization, HIV-positive men and women, and women of different ages from the mainstream South Asian community. The questions were adapted from the Explanatory Model Interview Catalog that has been widely used to assess health-related stigma. RESULTS HIV-related stigma was found to be high in Toronto's South Asian community. Respondents perceived it to be greater among South Asians than in other Canadian communities. South Asian families were said to harbor the most stigma, often rejecting HIV-positive members. Differences were noted between first- and second-generation South Asian migrants in knowledge about, and stigma toward, HIV. Women living with HIV were found to be particularly disadvantaged and stigmatized. Because of stigma, many people living with HIV concealed their illness and avoided HIV-related services. CONCLUSION Major gaps in knowledge about HIV among Canadian South Asians, and a considerable amount of stigma against people living with HIV, were found. The implications of stigma were highly problematic for people living with HIV, impeding access to services and social support. The paper concludes with recommendations to address stigma, based on suggestions from the study's participants.
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Affiliation(s)
- Carol Vlassoff
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada.
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Hartley S, Murira G, Mwangoma M, Carter J, Newton CRJC. Using community/researcher partnerships to develop a culturally relevant intervention for children with communication disabilities in Kenya. Disabil Rehabil 2009; 31:490-9. [PMID: 18720117 PMCID: PMC3595511 DOI: 10.1080/09638280802061944] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The objective of this study is to develop a culturally relevant community-based intervention for children with communication disabilities in Kenya through a community/researcher partnership. The resulting intervention is for use in a randomized control trial which will be reported at a later stage. METHOD Using a qualitative approach, initial data was collected through focus group discussions with women, disabled people and traditional dancers. The groups examined the needs, problems and challenges faced by disabled children and their families. This generated the content and structure for a series of participatory workshops with a further two women's groups. These workshops strove to generate a culturally relevant community-based intervention programme for children with communication disabilities and their families. The content and balance of the resulting intervention was observed to be different from existing programmes described in the literature. Notably it included many culturally appropriate strategies for increasing social integration and raising community awareness. RESULTS The process of generating a locally relevant community-based rehabilitation intervention is potentially transferable and has particular relevance to the estimated 80% of the world where there are no formal rehabilitation services for children with disabilities and where women's groups are a strong element of local culture. CONCLUSION (i) Community/researcher partnerships can be used to develop interventions; (ii) such interventions are different from those imported from other cultures; and (iii) this process is transferable and can be part of the preparations for a Randomized Control Trial.
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Affiliation(s)
- Sally Hartley
- Centre for International Health and Development, Institute of Child Health, London, UK.
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Steggall MJ, Fowler CG, Pryce A. Combination therapy for premature ejaculation: results of a small-scale study. SEXUAL AND RELATIONSHIP THERAPY 2008. [DOI: 10.1080/14681990802545532] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Griffiths C, Prost A, Hart G. Sexual and reproductive health of South Asians in the UK: an overview. JOURNAL OF FAMILY PLANNING AND REPRODUCTIVE HEALTH CARE 2008; 34:251-60. [DOI: 10.1783/147118908786000352] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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17
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Sinha S, Curtis K, Jayakody A, Viner R, Roberts H. 'People make assumptions about our communities': sexual health amongst teenagers from black and minority ethnic backgrounds in East london. ETHNICITY & HEALTH 2007; 12:423-441. [PMID: 17978942 DOI: 10.1080/13557850701616839] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES (1) To explore sexual behaviour and relationships amongst Black and minority ethnic (BME) teenagers in East London. (2) To examine how these relationships are shaped by culture, gender, peer norms and religion. (3) To describe the implications for sexual health policy and practice in urban, multicultural areas. DESIGN This report draws primarily on the qualitative arm of a mixed methods study which collected data from 126 young people, aged 15-18, largely through focus groups in the London boroughs of Hackney, Newham and Tower Hamlets. RESULTS Previous research has reported culture influencing the patterning of risk/protection amongst BME groups. Our data suggest that this is mediated by gender, religion and youth. Religion reportedly influenced young women's sexual behaviour in multiple ways. Young people described gendered norms in meeting and flirting with partners, and the role of mobile phones and peer pressure. CONCLUSION Our paper suggests culture, gender, religion and youth influence BME teenagers in aspects of sexual relationships, and that these social markers may have different contextual meanings for individuals. The multiplicity of factors affecting attitudes/behaviour requires a range of contraceptive, counselling, screening and sex education services available for all teenagers, although delivery patterns may differ in response to differing needs.
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Affiliation(s)
- Shamser Sinha
- Institute of Primary Care and Public Health, London South Bank University, London, UK.
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18
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Cheemeh PE, Montoya ID, Essien EJ, Ogungbade GO. HIV/AIDS in the Middle East: a guide to a proactive response. ACTA ACUST UNITED AC 2006; 126:165-71. [PMID: 16875056 DOI: 10.1177/1466424006066280] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
After 24 years of being declared an epidemic, the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) has found its way to the remote parts of the Middle East. There are no fastidious HIV/AIDS epidemiological data available specific for the Middle East and insufficient surveys have been conducted in a larger area including the Middle East and North Africa. Currently the total number of people living with HIV in the Middle East and North Africa is 540,000. About 92,000 individuals were newly infected in 2004 and 28,000 people have died of AIDS during the same time period.2 With increasing spread of sexually transmitted infections (STIs), injection drug users (IDUs), numbers of unemployed youth, a conservative culture and low awareness of HIV the region is especially vulnerable to a large-scale epidemic. In this age of globalization the rapid spread of HIV along with highly virulent and multi-drug-resistant HIV strains that progress rapidly to AIDS, the more difficult and expensive prevention efforts and treatment regimes become. Complicating the issue there are many unresolved socio-economic conflicts in the Middle East. Valid and reliable HIV/AIDS epidemiological data, to facilitate policy formulation and to effect urgent prevention intervention is inadequate. This article identifies numerous gaps and shortfalls in the existing programs, elucidates the reasons behind the lack of information, and provides suggestions for taking actions.
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Affiliation(s)
- Parvaneh Ehsanzadeh Cheemeh
- College of Pharmacy University of Houston, Houston, Texas, HIV Prevention Research Group, 1441 Moursund Street, Houston, Texas 77030, USA.
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Ross JDC, Copas A, Stephenson J, Fellows L, Gilleran G. Public involvement in modernising genitourinary medicine clinics: using general public and patient opinion to influence models of service delivery. Sex Transm Infect 2006; 82:484-8. [PMID: 16757514 PMCID: PMC2563868 DOI: 10.1136/sti.2006.020750] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To determine which of the options available to modernise genitourinary medicine (GUM) clinics in the UK are most acceptable to patients and potential patients; to assess whether the views of a general population sample differ from those of clinic attenders. . METHODS A questionnaire was used to explore the acceptability of different ways of delivering sexual healthcare including the potential trade-off between convenience/range of services with cost/staffing constraints. Potential differences in responses by age, sex, ethnicity and current attendance at a GUM clinic were evaluated using multivariate analysis. RESULTS 542 respondents in the community and 202 clinic attenders provided responses. Delivery of sexual healthcare by specialist nurses and general practitioners was acceptable to 81% and 72% of interviewees, respectively, assuming common protocols were adhered to. The proportion of individuals who would accept a consultation with a nurse increased to 91% if the waiting time for an appointment could be reduced as a result. Men were less likely to accept a consultation with a nurse (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.35 to 0.79), and Asian (OR 0.38, 95% CI 0.23 to 0.64) and other black (OR 0.41, 95% CI 0.2 to 0.87) ethnic groups were less likely to accept a consultation with a general practitioner. 44% of patients preferred walk-in clinics even if waiting times for an appointment were reduced to 48 h. CONCLUSION Delivery of sexual healthcare by nurses and general practitioners was generally found to be acceptable, although this varies by patient sex and ethnicity. Some differences exist between the preferences of a general population sample compared with clinic attenders, but overall there is a high level of concordance. Walk-in clinics remain a popular choice even when appointment waiting times are short.
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Affiliation(s)
- J D C Ross
- Whittall Street Clinic, Whittall Street, Birmingham B4 6DH, UK.
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