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Healthcare-seeking behaviour in relation to sexual and reproductive health among Thai-born women in Sweden: a qualitative study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. (Socialmedicinsk epidemiologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell kvinno- och mödrahälsovård och migration/Essén)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. (Socialmedicinsk epidemiologi)
Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
2017 (English)In: Culture, Health and Sexuality, ISSN 1369-1058, E-ISSN 1464-5351, Vol. 19, no 2, p. 194-207Article in journal (Refereed) Published
Abstract [en]

Thailand is one of the most common countries of origin among immigrants in Sweden and Thai immigrants comprise the immigrant group most frequently diagnosed with HIV. Little is known about their healthcare-seeking behaviour and views on HIV prevention. This study explored Thai women's healthcare-seeking behaviour in relation to sexual and reproductive health and their views on HIV prevention. Nineteen in-depth interviews were conducted with Thai-born women in the Stockholm area. Three themes were identified: (1) poor access to healthcare in Sweden, preferring to seek care in Thailand; (2) partners playing a key role in women's access to healthcare; (3) no perceived risk of HIV, but a positive attitude towards prevention. Despite expressing sexual and reproductive healthcare needs, most women had not sought this type of care, except for the cervical cancer screening programme to which they had been invited. Identified barriers for poor access to healthcare were lack of knowledge about the healthcare system and language difficulties. To achieve 'healthcare on equal terms', programmes and interventions must meet Thai women's healthcare needs and consider what factors influence their care-seeking behaviour. Integrating HIV prevention and contraceptive counselling into the cervical screening programme might be one way to improve access.

Place, publisher, year, edition, pages
2017. Vol. 19, no 2, p. 194-207
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-312021DOI: 10.1080/13691058.2016.1214746ISI: 000393781500004PubMedID: 27684388OAI: oai:DiVA.org:uu-312021DiVA, id: diva2:1062142
Available from: 2017-01-04 Created: 2017-01-04 Last updated: 2019-02-05Bibliographically approved
In thesis
1. Challenges and opportunities for sexual and reproductive healthcare services for immigrant women in Sweden
Open this publication in new window or tab >>Challenges and opportunities for sexual and reproductive healthcare services for immigrant women in Sweden
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis aims to obtain an understanding of immigrant women’s access to healthcare services in Sweden in relation to sexual and reproductive health and rights (SRHR). Data were obtained from three different quantitative cross-sectional studies using self-administrated questionnaires and one qualitative study based on in-depth interviews. The sample consists of immigrant women, predominantly refugees from Afghanistan, Iraq, Syria, and Somalia in Study I (n=288) and Thai immigrant women in Studies II–IV: Study II (n=804), Study III (n=19) and Study IV (n=266). The results indicate that social capital factors seem to play an important role in knowledge about sexual and reproductive health (SRH) services. About one-third of immigrant women reported lack of knowledge of where to go for contraceptive counselling. Lack of knowledge was associated with experiencing lack of emotional social support and not having children. An even higher proportion lacked knowledge of where to go for HIV testing, which was associated with not having participated in a health examination. In a sample of Thai immigrant women, lack of knowledge about SRH services was associated with living without a partner, having low trust in others, having predominantly bonding social relationships and belonging to the oldest age groups. In all studies, the majority had not been tested for HIV or participated in contraceptive counselling. Among the Thai women, despite expressing a need for SRH care, most participants had not sought this type of care. Women found it challenging to seek care in Sweden due to lack of knowledge about the healthcare system and language difficulties. The majority of Thai women reported a significant need for information related to SRH services. Women who had never been HIV tested in Thailand had increased odds of not being tested in Sweden.

Lack of knowledge of where to turn for contraceptive counselling and HIV testing among immigrant women is a missed opportunity, as all citizens in Sweden have free access to these services. Providing information on SRH services to all immigrants in their native language, regardless of immigration status, is an important step in achieving equal access to SRH care.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 86
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1540
Keywords
Immigrant, Migrant, Access, Healthcare, Equal, Social capital, Contraceptive counselling, HIV testing, HIV, Sexual and reproductive health and rights, Sweden.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine; Health Care Research
Identifiers
urn:nbn:se:uu:diva-368357 (URN)978-91-513-0573-8 (ISBN)
Public defence
2019-03-25, A1:111a, BMC, Husargatan, ingång A11, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2019-03-01 Created: 2019-02-05 Last updated: 2019-03-18

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Essén, BirgittaWesterling, Ragnar

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