Talking to young migrant and refugee patients about sexual health

Amanda Lyons

14/08/2018 2:25:22 PM

Sex can be a difficult topic to broach, especially with young migrant or refugee people who may feel uncomfortable in the first place. How can GPs make it easier for these patients?

Researcher Jessica Botfield says a proactive, non-judgemental approach is key when talking with young migrant and refugee patients about sexual health.
Researcher Jessica Botfield says a proactive, non-judgemental approach is key when talking with young migrant and refugee patients about sexual health.

‘The GPs are the only people that we know. And it’s a place that any young person, any person can go to, and they have the biggest capacity to actually help.’
These words were spoken by Liz*, who is 21 years old and of African heritage, during a study that was recently published in the Australian Journal of General Practice (AJGP), ‘Talking to migrant and refugee young people about sexual health in general practice’.
‘Young people from minority cultural and/or language backgrounds, including migrants, refugees and international students, have been shown in many settings to be at heightened risk of poor sexual and reproductive health,’ Jessica Botfield, the study’s lead author, told newsGP.
‘And the little that is known about how they use services for sexual and reproductive health suggests they may have limited engagement.
‘As general practice is usually the most well-known and accessible service for young people, it is important that young people from migrant and refugee backgrounds are able to access these services and feel comfortable to discuss these matters with a GP.’
Ms Botfield currently works for Family Planning NSW and is undertaking qualitative doctoral research. Her AJGP study recruited 27 young people aged 16–24 years living in Sydney who self-identified as being from a refugee or migrant background and spoke a language other than English at home.
Participants took part in several rounds of semi-structured interviews as a way of gaining a detailed perspective on their experiences of accessing sexual healthcare in general practice.
It was found that the young people perceived general practice as their first port of call for sexual health information and services – as exemplified by people like Liz*.
But the situation was not always so simple from there; for example, although many participants had a regular GP, they were reluctant to see this GP for matters of sexual health.
‘A number of the [participants] had a family doctor, often from a similar language and cultural background and whom they spoke positively about,’ Ms Botfield said.
‘However, most had concerns about discussing sexual health matters with them, mostly due to fears about confidentiality or being judged.’
Most of the participants preferred the idea of speaking with a more ‘anonymous’ GP from a different ethnic background than themselves. Many also preferred to speak about sexual matters in English rather than their own language. But many participants’ experiences with new, unknown GPs were not as helpful as they may have liked.
‘Participants described somewhat negative experiences of discussing these matters with some GPs, including not being listened to, being rushed through the appointment, and personal preferences or views not been taken into account,’ Ms Botfield explained.
The study’s authors concluded that a proactive, non-judgemental approach by GPs is important in consultations with young migrant and refugee patients.
‘Helpful approaches to talking about sexual and reproductive health include initiating these discussions during consultations with young people and providing opportunistic sexual health information and support,’ Ms Botfield said. ‘Also, avoiding making assumptions about young people and communicating confidentiality and trustworthiness will be essential in these efforts.
‘Practice nurses in general practice may also be able to contribute more to provision of primary healthcare for young people in this area.’
Ms Botfield believes there are significant benefits to be gained from taking such an approach to young migrant and refugee patients discussing sexual health in general practice.
‘Engaging young people in conversations around sexuality and sexual health and providing them with the information, care and support they need will promote optimal sexual and reproductive health and wellbeing,’ she said.
Access ‘Talking to migrant and refugee young people about sexual health in general practice’ in the August edition of AJGP for more information.

*Not her real name.

Refugee health Sexual and reproductive health Young peoples health

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