Background International travel has become increasingly popular among young adults. Young adults often engage in casual sexual relationships abroad, exhibit sexual risk behaviours and may thus be at risk of contracting sexually transmitted and blood-borne infections. Pre-travel interventions and consultations may mitigate this risk. At present, we know little about sexual health-related pre-travel interventions. The aim of this study was therefore to document key informants’ experiences, perceptions and recommendations in the context of sexual health of young adult travellers. Methods Key informants were professionals working in Ottawa, Canada travel clinics, travel organizations or sexual health clinics with a young adult clientele. This study used a qualitative approach and consisted of 13 in-person or Skype semi-structured interviews with key informants. Thematic content analysis was informed by a sexual health framework, with themes emerging both inductively and deductively. Results Sexual health was not common in pre-travel interventions described by key informants. Risk-assessment, and practical or purpose-driven pre-travel interventions were identified, resulting in risk mitigation strategies tailored to the destination region and/or mission/culture of the travel organization. Dissemination (e.g. limited time, lack of training) and uptake (e.g. young adults’ embarrassment, provider discomfort, financial constraints) barriers limited in-depth discussions of pre-travel interventions related to sexual health. Key informants acknowledged the importance of early sexual health education, and recommended ongoing, comprehensive sexual education for both youth and young adults. Conclusion The findings of this study suggest that more time and resources should be allocated to the topic of sexual health during pre-travel interventions with young adults. Professionals who guide and prepare young adults for travel must develop concomitant skills in sexual health promotion. Early, comprehensive sexual education is recommended to improve overall sexual health in young adults and mitigate risk behaviours during travel.

Background For young adults, travel- an accessible and aspirational experience- may be accompanied by high-risk lifestyle behaviors abroad, which in turn, increases the risk of sexually transmitted and blood-borne infections (STBBI). This study aimed to examine sexual and risk behaviors of young Canadian adults both at-home and during international travel. Methods Sexually-active Canadians, aged 18-25 years (N = 646) who travelled abroad in 2016, completed an online, cross-sectional survey analyzed by descriptive statistics. Outcome measures included young Canadian adults’ lifestyle risk and sexual behaviors at-home and abroad. Results Sexual behaviors, both penetrative and non-penetrative activities, decreased significantly (p < 0.001; McNemar test) abroad compared to at-home. International travel elicited a statistically significant increase in alcohol consumption compared to at-home (Wilcoxon, z = − 11.341, p < 0.001). Partner type (new trip-acquired partner) abroad was associated with a greater number of travel-acquired sexual partners (Mann-Whitney, U = 4901, p < 0.001), inconsistent condom use during penetrative sex (U = 7215, p = 0.009), and sex under the influence of alcohol (Test of Two Proportions, p < 0.001). Conclusions Although many young Canadian respondents practiced abstinence in their 2016 travel, for sexually-active travelers, new partner-type was related to high risk sexual behaviors. Young Canadians exhibited sexual risk behaviors both at-home and while travelling; suggesting the need for both domestic and pre-travel sexual health interventions.

Multiple studies have described the relationship between discrimination and health outcomes among gay, bisexual, and other men who have sex with men (GBMSM). However, little attention has been paid to prejudiced events in workplace environments. Rooted in a social determinant of health framework, we sought to examine associations between sexuality-based workplace discrimination (SBWD) and health outcomes in an online survey of Canadian GBMSM (N = 7,872). A minority (6.5%) of GBMSM reported past-year SBWD, which was more common among those identified as queer, Latino, Aboriginal, single, or with annual income less than CAD $30,000. GBMSM partnered with a man or woman reported less SBWD than single men. After adjusting for sociodemographics, SBWD was positively associated with having discussed depression and anxiety with a healthcare provider, suicidality, sexually transmitted infections (STIs), and intimate partner violence (IPV). More GBMSM who reported SBWD rated their health as poor, as compared with those who did not report SBWD. This is the first study to examine SBWD as a social determinant of health among Canadian GBMSM. Findings document that despite the social and legal gains of the last three decades, about 1 in 15 GBMSM report recent workplace discrimination due to their sexuality, which threatens their health. Work-based policies and interventions are urgently needed to provide safer workplace environments for sexual minorities.

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