Talking to migrant and refugee young people about sexual health in general practice

‘They say “I did it”, but they don’t say “I got an STI from it”’: Exploring the experiences of youth with a migration background with sexual health in Amsterdam, the Netherlands

“…Unsafe cultural practice 'comprises any action which diminishes, demeans or disempowers the cultural identity and wellbeing of an individual' (NCNZ, 2011, p. 7). Culturally safe care would entail, for instance, easy-to-find and actively communicated information about confidentiality in various languages, a communication policy aimed at making clients of all backgrounds feel welcome (for instance diverse representation in visual material), and culturally sensitive providers (Botfield et al, 2018;Hällström et al, 2017). At the same time, local sexual health services can facilitate conversations about sexual health risk by providing educational outreach programmes through (youth) participatory projects in the community (Ozer et al, 2020), working in close collaboration with local stakeholders such as youth groups and high schools.…”

“…Evidence suggests that youth with a migration background are currently underserved by sexual healthcare (Baroudi et al, 2020; J. R. Botfield et al, 2018;Wray et al, 2014) and at higher risk for adverse sexual health outcomes (Newton et al, 2013). In the Netherlands, multiple studies have reported disparities between youth with a migration background and native Dutch youth in, for instance, sexually transmitted infections (STIs) (Matser et al, 2013) and abortion rates (de Graaf et al, 2017;Wijsen & Rademakers, 2003).…”

“…Several explanations for these disparities exist. For instance, they might result from underuse of sexual health services caused by barriers at the patient and provider level (Botfield et al, 2018;Manderson & Allotey, 2003;McMichael & Gifford, 2009). Youth might lack awareness of sexual health services, or might avoid using these services because they are considered inappropriate or shameful based on taboos that exist in their communities (Botfield et al, 2018;Cense, 2014;Cense & Ganzevoort, 2017).…”

“…For instance, they might result from underuse of sexual health services caused by barriers at the patient and provider level (Botfield et al, 2018;Manderson & Allotey, 2003;McMichael & Gifford, 2009). Youth might lack awareness of sexual health services, or might avoid using these services because they are considered inappropriate or shameful based on taboos that exist in their communities (Botfield et al, 2018;Cense, 2014;Cense & Ganzevoort, 2017). In addition, underuse might be caused by reduced sexual health literacy as a result of the impact of structural marginalisation (Metusela et al, 2017;Svensson et al, 2017).…”

Prescribing for adolescents

“…12 A recent qualitative study involving young women (16-24 years) of culturally diverse backgrounds also suggested that clinicians may be selective about the contraception options they offer. 13 The uptake of long-acting reversible contraceptives has been slow among Australian women, despite them being recommended as first-line options for nulliparous ARTICLE Full text free online at nps.org.au/australian-prescriber Prescribing for adolescents women in Australia, the USA and the UK. 14 This may be because Australian women and clinicians are unfamiliar with long-acting reversible contraceptives, compared to the combined oral contraceptive pill.…”