Abstract
BackgroundAlthough migrants constitute an important proportion of the European population, little is known about migrant sexual health. Existing research mainly focuses on migrants’ sexual health risks and accessibility issues while recommendations on adequate sexual health promotion are rarely provided. Hence, this paper explores how refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands define sexual health, search for sexual health information and perceive sexual health determinants.MethodsApplying Community-based Participatory Research as the overarching research approach, we conducted 223 in-depth interviews with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. The Framework Analysis Technique was used to analyse qualitative data. We checked the extensiveness of the qualitative data and analysed the quantitative socio-demographic data with SPSS.ResultsOur results indicate that gender and age do not appear to be decisive determinants. However, incorporated cultural norms and education attainment are important to consider in desirable sexual health promotion in refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. Furthermore, our results demonstrate that these migrants have a predominant internal health locus of control. Yet, most of them feel that this personal attitude is hugely challenged by the Belgian and Dutch asylum system and migration laws which force them into a structural dependent situation inducing sexual ill-health.ConclusionRefugees, asylum seekers and undocumented migrants in Belgium and the Netherlands are at risk of sexual ill-health. Incorporated cultural norms and attained education are important determinants to address in desirable sexual health promotion. Yet, as their legal status demonstrates to be the key determinant, the prime concern is to alter organizational and societal factors linked to the Belgian and Dutch asylum system. Refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands should be granted the same opportunity as Belgian and Dutch citizens have, to become equally in control of their sexual health and sexuality.
Highlights
Migrants constitute an important proportion of the European population, little is known about migrant sexual health
This paper aims to explore how refugees, asylum seekers and undocumented migrants define sexual health; to examine what pathways they use in search of sexual health information and to identify risk and protective factors they perceive as determinants after having fled to and applied for asylum in Belgium or the Netherlands
Our results demonstrate that being a refugee, asylum seeker or undocumented migrant in Belgium and the Netherlands is a risk factor for sexual ill-health and confirms that migration and legal status in this matter can be considered a health determinant as such [74]
Summary
Migrants constitute an important proportion of the European population, little is known about migrant sexual health. Since the recognition of sexual and reproductive health as a human right at the International Conference of Population and Development of 1994 in Cairo, more need was felt to come to a global consensus. Starting from this rights-based and public health approach, the World Health Organisation (WHO, 2010) defines sexual health as “a state of physical, emotional, mental and social wellbeing in relation to sexuality; and is not merely the absence of disease, dysfunction or infirmity. The WHO defines sexuality as: “A central aspect of human being throughout life which encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious and spiritual factors” [2]
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