Pathways to Sexual Health Among Refugee Young Women: A Contextual Approach

Abstract

Refugee youth face sexual health challenges, and research investigating contributing factors has primarily focused on identifying contextual barriers. However, it is also important to investigate protective factors, as well as how risk and protective factors work together across contexts. The present study explored both contextual facilitators and barriers to refugee young women’s sexual health and how these factors intersect to influence behavior. Interviews were conducted with twelve female refugees ages 18-24. Participants’ countries of origin included Burma, Central African Republic, the Democratic Republic of Congo, and Somalia; most participants had lived in the United States for over five years. Data were analyzed using thematic text analysis and narrative analysis. Findings revealed four primary themes: sex/relationship restrictions, judgment/disapproval, support, and youth outcomes. Themes varied by context (e.g., family, peers, religion, culture) and were related to one another in important ways, such that refugee young women who violate sociocultural sex/relationship expectations experience actual or anticipated judgment from others, which leads to fear, embarrassment, and risky sexual behavior. However, participants also shared that social and institutional support would contribute to improved sexual health outcomes. Findings highlight the importance of considering refugee young women’s sociocultural contexts when addressing sexual health challenges.