“It was protected, except, it wasn’t [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia

Abstract Background A number of previous sex-related studies among international students in Australia and other Western societies may be limited by conflating students from conservative and non-conservative sexual backgrounds. Such conflation leads to situations where nuances and complexities aroun...

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Main Author: Sylvester Reuben Okeke
Format: Article
Language:English
Published: BMC 2022-11-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-022-14512-y
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author Sylvester Reuben Okeke
author_facet Sylvester Reuben Okeke
author_sort Sylvester Reuben Okeke
collection DOAJ
description Abstract Background A number of previous sex-related studies among international students in Australia and other Western societies may be limited by conflating students from conservative and non-conservative sexual backgrounds. Such conflation leads to situations where nuances and complexities around sex-related experiences are lost or, at most, tangentially investigated. To address this research problem, this study used a mixed-methods design to examine protective practices against blood-borne viruses and sexually transmissible infections (BBVs/STIs) among Sydney-based East Asian and sub-Saharan African international students. Methods This mixed-methods study generated quantitative data using anonymous online survey (n = 149), and qualitative data through in-depth interviews (n = 20). The main recruitment strategy involved advertising the study through paper and electronic flyers. Quantitative data were analysed using logistic regression, while interviews data were analysed using reflexive thematic analysis. Results Self-reported BBVs/STIs protective practices in the last 12 months include abstinence (28.7%), consistent condom use (19.9%), occasional condom use (18.7%), single partner fidelity (25.1%), other strategies (1.8%), and nothing (5.8%). Further, findings from the bivariate analysis showed higher BBVs/STIs prevention knowledge, lower acculturation into Australian sexual culture, greater access to sexual health information, less conservative sexual norms, greater emotional social support and older age were significantly associated with increased protective practices. Variables significant at bivariate level were entered into a logistic regression. The model was statistically significant, (X 2(6) = 31.33, p < 0.01) and explained 33.1% of the variance in BBVs/STIs protective practices. However, only acculturation to sexual norms in Australia (OR = 0.883, 95% CI = 0.820–0.952) was found to be independent predictor of BBVs/STIs protective practices. The results of the study based on the quantitative data, indicated condom use (consistent and occasional) was the most reported BBVs/STIs protective behaviour among sexually active participants. Therefore, interviews data was used to explore condom-use motives and practices. The interviews results showed participants primary concern as regards condom use was around pregnancy and not BBVs/STIs. Thus, some participants described safe sex largely as contraception, with BBVs/STIs constituting a secondary concern or no concern at all. Conclusions Based on the results of this study, tailored sexual health interventions for international students; which incorporate strategies for modifying perceived sexual norms in Australia, are advocated. In addition, this study recommends sexual health interventions that promote dual protection of condoms for both contraception and BBVs/STIs.
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spelling doaj.art-03302dba07294fcfa548bb67e0ad62212022-12-22T04:20:25ZengBMCBMC Public Health1471-24582022-11-0122111610.1186/s12889-022-14512-y“It was protected, except, it wasn’t [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, AustraliaSylvester Reuben Okeke0Centre for Social Research in Health, UNSW SydneyAbstract Background A number of previous sex-related studies among international students in Australia and other Western societies may be limited by conflating students from conservative and non-conservative sexual backgrounds. Such conflation leads to situations where nuances and complexities around sex-related experiences are lost or, at most, tangentially investigated. To address this research problem, this study used a mixed-methods design to examine protective practices against blood-borne viruses and sexually transmissible infections (BBVs/STIs) among Sydney-based East Asian and sub-Saharan African international students. Methods This mixed-methods study generated quantitative data using anonymous online survey (n = 149), and qualitative data through in-depth interviews (n = 20). The main recruitment strategy involved advertising the study through paper and electronic flyers. Quantitative data were analysed using logistic regression, while interviews data were analysed using reflexive thematic analysis. Results Self-reported BBVs/STIs protective practices in the last 12 months include abstinence (28.7%), consistent condom use (19.9%), occasional condom use (18.7%), single partner fidelity (25.1%), other strategies (1.8%), and nothing (5.8%). Further, findings from the bivariate analysis showed higher BBVs/STIs prevention knowledge, lower acculturation into Australian sexual culture, greater access to sexual health information, less conservative sexual norms, greater emotional social support and older age were significantly associated with increased protective practices. Variables significant at bivariate level were entered into a logistic regression. The model was statistically significant, (X 2(6) = 31.33, p < 0.01) and explained 33.1% of the variance in BBVs/STIs protective practices. However, only acculturation to sexual norms in Australia (OR = 0.883, 95% CI = 0.820–0.952) was found to be independent predictor of BBVs/STIs protective practices. The results of the study based on the quantitative data, indicated condom use (consistent and occasional) was the most reported BBVs/STIs protective behaviour among sexually active participants. Therefore, interviews data was used to explore condom-use motives and practices. The interviews results showed participants primary concern as regards condom use was around pregnancy and not BBVs/STIs. Thus, some participants described safe sex largely as contraception, with BBVs/STIs constituting a secondary concern or no concern at all. Conclusions Based on the results of this study, tailored sexual health interventions for international students; which incorporate strategies for modifying perceived sexual norms in Australia, are advocated. In addition, this study recommends sexual health interventions that promote dual protection of condoms for both contraception and BBVs/STIs.https://doi.org/10.1186/s12889-022-14512-yAcculturationMigrationHIVCondomContraceptionSexual norms
spellingShingle Sylvester Reuben Okeke
“It was protected, except, it wasn’t [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia
BMC Public Health
Acculturation
Migration
HIV
Condom
Contraception
Sexual norms
title “It was protected, except, it wasn’t [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia
title_full “It was protected, except, it wasn’t [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia
title_fullStr “It was protected, except, it wasn’t [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia
title_full_unstemmed “It was protected, except, it wasn’t [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia
title_short “It was protected, except, it wasn’t [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia
title_sort it was protected except it wasn t with a condom a mixed methods study of bbvs stis protective practices among international university students in sydney australia
topic Acculturation
Migration
HIV
Condom
Contraception
Sexual norms
url https://doi.org/10.1186/s12889-022-14512-y
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