\u201cI always prefer to withdraw than use a condom\u201d: contextualising condomless sex among East Asian and sub-Saharan African international students in Sydney

Sylvester R Okeke

doi:10.1186/s13690-021-00777-z

Abstract

BackgroundIncidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use. This study examined condomless sexual practice among a sample of East Asian and sub-Saharan African international university students in Sydney, Australia.MethodsThis qualitative study was methodologically guided by interpretative phenomenological analysis. Data was provided by 20 international students sampled from five universities in Sydney, who participated in either face-to-face or telephone semi-structured in-depth interviews. The interview sessions were audio-recorded, transcribed verbatim, coded in NVivo and analysed using reflexive thematic analysis.ResultsCondomless sexual practices appear to be common among the study group based on participants’ self-reports of their own practices and the practices of friends and peers. Three themes contextualising condomless among the study participants were generated from the interview transcripts: (1) unanticipated sex, condom related stigma and alcohol use (2) pleasure-seeking, curiosity and intimacy (3) condomless sex as a gendered practice.ConclusionsThe result of this study has implications for public health research, practice and policy around design, implementation and evaluation of multi-layered and population-specific sexual health services that are tailored to addressing the needs of international students, who migrate from traditional sexual cultures to Australia, where sexual norms are more liberal.

Highlights

Incidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use
Nineteen of the twenty participants identified as heterosexuals while the remaining participant identified as gay
Most participants, sixteen out of twenty were never married and eleven of the twenty participants identified as females

Summary

Introduction

Incidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use. This study examined condomless sexual practice among a sample of East Asian and sub-Saharan African international university students in Sydney, Australia. Despite progress in improving sexual and reproductive health outcomes of young people in recent decades, they continue to constitute a key population for transmitting blood-borne viruses (BBVs) and sexually transmissible infections (STIs). The present study adds to this body of knowledge by contextualising condomless sex among East Asian and sub-Saharan African international students in Sydney, based on their lived experiences and construction of their social realities.

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