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Sexual violence (SV) is pervasive on university campuses worldwide, with alarmingly high reported rates in sub-Saharan Africa (SSA). Despite the high reported rates of SV victimization on campuses, existing evidence has not been critically synthesized to give a comprehensive picture of the problem’s extent, common forms, risk factors, and (knowledge about) victims and perpetrators in SSA countries. We aimed to map the existing literature on SV prevalence, types, risk factors, victims, perpetrators, and consequences among university students on campuses in SSA. We included articles focusing on university students from SSA countries published in English or French language from 2014 to 2023. We identified 543 records from nine databases; Academic Search Premier; CINAHL; EMBASE; MEDLINE; PsychINFO; PubMed; Scopus; SocINDEX; and Web of Science, 82 of which met our inclusion criteria. Retrieved articles covered only one-third of the sub-Saharan region, mostly focusing on female students and victims. Prevalence of different forms of SV varied among countries; authors attributed these variations to differences in time frame, forms of SV, how they were defined, and the tools used. Young female students were identified as common victims, while male teachers and students were common perpetrators. We used the socio-ecological model to summarize risk and protective factors associated with SV victimization and listed the health, social, and economic consequences of SV victimization. Despite these consequences, victims rarely seek help, whether from informal sources or authorities. We call for comprehensive studies in SSA that include both genders and focusing on victims and perpetrators, and address service access barriers.

BACKGROUND: Previous research has highlighted inequalities in access to Swedish youth clinics (YCs). These inequalities exist not only between non-migrant and young migrant populations but also within various migrant groups. OBJECTIVES: To assess awareness and utilization of Swedish YCs among migrants enrolled in Swedish language programmes and explore associated factors.

METHODS: This cross-sectional study involved 1,112 migrants aged 15-65. The analytical sample included 642 (57%) participants who answered the main outcome question about awareness of YCs. Descriptive statistics, bivariate, and multivariate log-binomial regression analyses using a Bayesian approach were applied to summarize the data and identify factors associated with awareness and utilization of YCs among migrants.

RESULTS: The results revealed that 30% of all participants and 40% of the participants aged 15-25 years had heard of YCs. Additionally, 23% of the target group (15-25 years) had ever visited one. During descriptive and bivariate analyses, socio-demographic variations were evident in YCs' awareness and utilization. However, in multivariate analyses, only the associations between awareness and year of arrival, and YCs' utilization and year of arrival and type of residence permit, remained statistically significant.

CONCLUSION: This study highlights the level of awareness of YCs among migrants attending Swedish language programmes and their utilization by those aged 15-25 years, potentially impacting their access to crucial services and resources. Targeted interventions and sustainable strategies beyond one-time interventions are essential to address the specific needs of different socio-demographic groups and ensure equitable access to YCs' information and services.

Background: Sweden has welcomed migrants, but attitudes have shifted, becoming hostile due to populism and the growing number of migrants. This has left migrants feeling unwelcome and marginalized. Few studies have examined the extent to which migrants perceive discrimination, who, why, where and its relationships with different outcomes. This study has two aims: to assess the prevalence, reasons, and determinants of perceived discrimination among migrants (1) and its associations with self-rated health, sexual health, healthcare use, and integration (2).

Methods: We analysed data from a 2018 survey on migrants' sexual and reproductive health and rights. The survey included 1740 migrants aged 16 or older. We used descriptive and log-binomial regression analyses to estimate prevalence, crude and adjusted prevalence ratios (APR) with 95% confidence interval (CI).

Results: About 36% of participants perceived discrimination in Sweden, with ethnic origin (62%) and religion (35%) as main reasons. Perceived discrimination occurred in public spaces (47%), schools (33%), internet (20%), work (19%), public services (18%), residential areas (16%), and healthcare settings (10%). Migrant men (APR: 1.26, CI:1.07–1.49), born in Middle East and North Africa (APR: 1.57, CI:1.26–1.95) and South Asia (APR: 1.61, CI:1.27–2.04) regions, with more than 12 years of education (APR: 1.33, CI:1.10–1.60), a non-heterosexual orientation (APR: 1.21, CI: 1.02–1.43), a non-Christian religion (APR: 1.41, CI: 1.10–1.80), economic stress (APR:1.67, CI: 1.44–1.93) or Swedish language skills (APR: 1.24, CI:1.07–1.43) perceived discrimination more than their counterparts. In contrast, the oldest participants (46 years or more) perceived less discrimination (APR:0.55, CI: 0.37–0.80) than the youngest ones (16–25 years). Moreover, perceived discrimination was associated with poor self-rated general (APR:1.72, CI: 1.45–2.04) and sexual health (APR:1.40, CI:1.2–1.64), integration (APR:1.25, CI:1.14–1.37), and healthcare access (APR: 1.48, 1.16–1.89).

Conclusions: This study shows that migrants in Sweden face widespread perceived discrimination based on ethnicity and religion. This can affect their health, healthcare use, and social integration. The study calls for policies and interventions that tackle systemic perceived discrimination, foster inclusion, and guarantee equal opportunities in accessing healthcare and resources for migrants. It also urges support for vulnerable groups who perceive more discrimination, such as migrants from certain regions or under economic stress.

Objectives: This study aims to map sexual and reproductive health and rights (SRHR) policies, strategies, and interventions targeting young migrants and describe the patterns of organisation, resources, and services across Sweden’s 21 regions.

Methods: We conducted a document analysis of accessible online documents on SRHR policies, strategies, and interventions targeting young migrants in Sweden’s 21 regions. We used ideal-type analysis of the documents to create a typology, which formed the basis of a ratings system illustrating variations in organisation, resources, and services across regions.

Results: Findings suggest that efforts aimed at addressing young migrants’ SRHR are fragmented and unequal across regions. While SRHR policies and strategies are commonplace, they routinely lack specificity. Available resources vary depending on region and resource type. Additionally, information and interventions, although common, do not consistently meet the specific needs of migrant youths.

Conclusion: This study suggests that fragmented efforts are fuelling geographic inequalities in fulfilling SRHR among young migrants. There is an urgent need to improve national coordination and collaboration between national and local actors in SRHR efforts targeting young migrants to ensure equity.

Background: Young migrants are particularly vulnerable to SV (SV) due to their age and the challenges of migration. However, there is limited knowledge regarding SV among young migrants in Sweden. This study aims to assess the prevalence, determinants, perpetrators, and reporting patterns of SV and rape.

Methods: We analyzed data from the 2018 survey on migrants’ sexual and reproductive health and rights, involving 1773 migrants aged 16–29. We estimated prevalence rates and calculated crude and adjusted prevalence ratios (APR) with 95% confidence intervals (CI) using descriptive and log-binomial regression analyses.

Results: The overall prevalence of SV was 25.1%, with rape at 9%. Higher SV prevalence were reported by non-binary individuals (APR: 2.60, CI: 1.54 to 4.38), Lesbian, Gay, Bisexual and Asexual (LGBA) individuals (APR: 1.56, CI: 1.22 to 2.01), those with 10–12 years (APR: 1.35, CI: 1.04 to 1.74) and over 12 years of education (APR: 1.61, CI: 1.23 to 2.11), and migrants awaiting asylum decisions (APR: 1.67, CI: 1.25 to 2.23). Rape prevalence was higher among those born in non-conflict settings (APR: 2.38, CI: 1.43 to 3.97), non-binary individuals (APR: 3.32, CI: 1.35 to 8.18), and LGBA individuals (APR: 1.68, CI: 1.02 to 2.75). Although men reported higher SV and rape levels than women in descriptive and bivariate analyses, these differences were not significant in multivariate analyses. Perpetrators included strangers (46.3%), partners (24.8%), family/friends (15.8%), and colleagues (15.4%). Most survivors did not report SV (63.7%) but confided in friends/relatives (29%) and trusted individuals like teachers/counselors (9.5%), with fewer reporting to authorities (3.4%).

Conclusion: The findings urge policymakers to prioritize targeted interventions, raise awareness, provide comprehensive support services tailored to the diverse needs of migrant groups, various perpetrator types, and the individual, systemic, and structural factors influencing reporting behaviors. These initiatives should adopt a migration-trajectory approach that recognize that migrants may have experienced SV throughout their journey and consider the unique experiences and vulnerabilities of non-binary individuals, LGBA individuals, those with low education levels, and migrants without formal residence status, regardless of their origin.

INTRODUCTION: Sexual violence (SV) is highly prevalent among university campuses across the globe, despite of several initiatives implemented to address it. Several studies have been published focusing on various aspects of SV on campuses. However, no review has been retrieved from the Joanna Briggs Institute (JBI) Database, Cochrane Library or Ovid examining evidence synthesis on prevalence, risk factors, victims and perpetrators, policies, laws and universities responses to SV in sub-Saharan Africa (SSA). This review aims to map the existing literature on SV victimisation among university students in SSA, related response strategies, and identify gaps in the evidence.

METHODS AND ANALYSIS: This review will follow JBI guidelines and will be conducted from 1 July 2023 to 31 December 2023. A team of five reviewers will screen eligible documents and articles for relevance from various data sources including electronic databases such as MEDLINE, EMBASE, PsycINFO, CINAHL, Google Scholar, PubMed and websites for government and agencies. Standard information for each study will be collected and a common analytical framework for all the primary documents will be conducted.

ETHICS AND DISSEMINATION: This review will involve analysis of published data only and therefore does not require ethics approval. The results will be published in a peer-reviewed journal.

REGISTRATION: This review has been registered with the Open Science Framework.

Around 40% of people living with human immunodeficiency virus (HIV) in Sweden are women. However, little is known about their experiences, particularly those related to sexual and reproductive health and rights (SRHR). This study aims to explore perceptions and experiences of SRHR among women living with HIV (LWH). Twelve interviews were conducted with women LWH from September to October 2019 and analysed using thematic analysis. The central theme describing participants’ experiences of social relationships, intimate encounters and reproductive life, “Discrimination is harder to live with than the disease itself”, is based on three themes that contain subthemes. Theme 1 describes how participants reconsider and reorient their sexual and reproductive life after diagnosis. Theme 2 highlights how (mis)perceptions of HIV affect sexual and reproductive life and lead to abusive treatment and internalisation. Theme 3 describes a paradoxical shift of responsibilities where participants experience being compelled to take greater responsibility in some situations and stripped of the right to decide in others. This study suggests that despite notable progress in HIV treatment, stigma and discrimination stemming from outdated beliefs and (mis)conceptions, ambiguous policies and guidelines, and unequal access to information affect SRHR experiences of women LWH more than the virus itself. The results emphasise the need to: update knowledge within healthcare settings and among the public; clarify ambiguous legislations and guidelines; ensure equal access to information to enable all women LWH to take informed decisions, make fully informed choices and realise their SRHR; and consider the diversity of women LWH and enable shared decision-making.

En Suède, les femmes représentent près de 40% des personnes vivant avec le virus de l’immunodéficience humaine (VIH). Pourtant, on sait peu de choses sur leurs expériences, en particulier celles qui se rapportent à la santé et aux droits sexuels et reproductifs. Cette étude souhaite explorer les perceptions et les expériences de la santé et des droits sexuels et reproductifs chez les femmes vivant avec le VIH. Douze entretiens ont été menés avec des femmes séropositives entre septembre et octobre de 2019, et ont fait l’objet d’une analyse thématique. « La discrimination est plus difficile à vivre que la maladie elle-même » est le thème central qui décrit les expérience des participantes en matière de relations sociales, de rencontres intimes et de vie reproductive. L’analyse est fondée sur trois thèmes qui contiennent des sous-thèmes. Le thème 1 décrit comment les participantes revoient et réorientent leur vie sexuelle et reproductive après le diagnostic. Le thème 2 met en lumière comment les idées (erronées) sur le VIH influent sur la vie sexuelle et reproductive et conduisent à des traitements abusifs et à l’intériorisation. Le thème 3 décrit un déplacement paradoxal des responsabilités où les participantes sont contraintes d’assumer une plus grande responsabilité dans certaines situations et sont privées du droit de décider dans d’autres. Cette étude suggère qu’en dépit des progrès notables accomplis dans le traitement du VIH, la stigmatisation et la discrimination découlant de croyances obsolètes et d’idées erronées, de politiques et de directives ambiguës, et d’un accès inégal à l’information influent davantage sur les expériences des femmes vivant avec le VIH en matière de santé et droits sexuels et reproductifs que le virus lui-même. Les résultats mettent en évidence la nécessité: de mettre à jour les connaissances dans les établissements des soins de santé et parmi le grand public; de clarifier les législations et les directives ambiguës; de garantir l’accès sur un pied d’égalité à l’information afin de permettre à toutes les femmes vivant avec le VIH de prendre des décisions éclairées, de faire des choix pleinement informés et de réaliser leurs droits à la santé sexuelles et reproductive; de tenir compte de la diversité des femmes vivant avec le VIH et de permettre une prise de décision partagée.

Aproximadamente el 40% de las personas que viven con el virus de inmunodeficiencia humana (VIH) en Suecia son mujeres. Sin embargo, no se sabe mucho sobre sus experiencias, en particular aquellas relacionadas con la salud y los derechos sexuales y reproductivos (SDSR). Este estudio pretende explorar las percepciones y experiencias de SDSR entre mujeres que viven con VIH (MVVIH). Se realizaron 12 entrevistas con MVVIH de septiembre a octubre de 2019, las cuales se analizaron con análisis temático. “Es más difícil vivir con discriminación que con la enfermedad” es el tema central que describe las experiencias de las participantes con relaciones sociales, encuentros íntimos y su vida reproductiva. Se basa en tres temas que contienen subtemas. El tema 1 describe cómo las participantes reconsideran y reorientan su vida sexual y reproductiva después del diagnóstico. El tema 2 destaca cómo las percepciones (erróneas) del VIH afectan la vida sexual y reproductiva y propician un trato abusivo e internalización. El tema 3 describe un cambio paradójico de responsabilidades mediante el cual las participantes se sienten obligadas a asumir mayor responsabilidad en algunas situaciones y despojadas de su derecho a decidir en otras. Este estudio indica que, a pesar de notables avances en el tratamiento del VIH, el estigma y la discriminación derivados de creencias y conceptos (erróneos) obsoletos, políticas y directrices ambiguas, y acceso no equitativo a la información afectan las experiencias de SDSR de las MVVIH más que el virus. Los Resultados Ponen de Relieve la Necesidad de: Actualizar los Conocimientos en los Establecimientos de Salud y en el Público; aclarar legislaciones y directrices ambiguas; garantizar acceso equitativo a la información para que todas las MVVIH puedan tomar decisiones informadas, hacer elecciones completamente informadas y realizar su SDSR; y considerar la diversidad de MVVIH y permitir la toma de decisiones compartida.

Background: This study aims to assess migrant youths’ access to sexual and reproductive healthcare (SRHC) in Sweden, to examine the socioeconomic differences in their access, and to explore the reasons behind not seeking SRHC. 

Methods: A cross-sectional survey was conducted for 1739 migrant youths 16 to 29 years-old during 2018. The survey was self-administered through: ordinary post, web survey and visits to schools and other venues. We measured access as a 4-stage process including: healthcare needs, perception of needs, utilisation of services and met needs. 

Results: Migrant youths faced difficulties in accessing SRHC services. Around 30% of the participants needed SRHC last year, but only one-third of them fulfilled their needs. Men and women had the same need (27.4% of men [95% CI: 24.2, 30.7] vs. 32.7% of women [95% CI: 28.2, 37.1]), but men faced more difficulties in access. Those who did not categorise themselves as men or women (50.9% [95% CI: 34.0, 67.9]), born in South Asia (SA) (39% [95% CI: 31.7, 46.4]), were waiting for residence permit (45.1% [95% CI: 36.2, 54.0]) or experienced economic stress (34.5% [95% CI: 30.7, 38.3]) had a greater need and found more difficulties in access. The main difficulties were in the step between the perception of needs and utilisation of services. The most commonly reported reasons for refraining from seeking SRHC were the lack of knowledge about the Swedish health system and available SRHC services (23%), long waiting times (7.8%), language difficulties (7.4%) and unable to afford the costs (6.4%). 

Conclusion: There is an urgent need to improve migrant youths’ access to SRHC in Sweden. Interventions could include: increasing migrant youths’ knowledge about their rights and the available SRHC services; improving the acceptability and cultural responsiveness of available services, especially youth clinics; and improving the quality of language assistance services.

BACKGROUND: Migrants are overrepresented among people living with HIV in Sweden as they often face conditions that increased their risk and vulnerability for HIV/STI infections prior, during or after migration. Yet, there is limited research on their experiences and perceptions of living with HIV in the Swedish context. This study aims to explore migrants' experiences of living with HIV in Sweden.

METHODS: This is a qualitative study based on in-depth interviews with 13 migrants from 11 countries living with HIV in Sweden. Interviews were analysed with thematic analysis using an intersectional perspective to explore the interactions of multiple social identities such as ethnicity, socio-economic status, gender, age, and sexual orientation that shape an individual's or group's experiences.

RESULTS: The analysis resulted in a main theme: 'Prioritizing social integration-HIV ends up in second place', which is based on four subthemes: 'Better opportunities in the new country than what the home country could offer', 'Better conditions for LGBTQI people than in the home country', 'Navigating a new system: linguistic and bureaucratic challenges' and 'Feeling like a second-class resident: racism, xenophobia and multiple discrimination'. The results suggest that migrants living with HIV in Sweden experience social integration as a greater challenge than HIV infection. Although the new country offers opportunities for better living conditions, many participants described being challenged in their daily life by linguistic and structural barriers in their encounters with public services. They are facing multiple discrimination simultaneously as migrants due to their multiple and intersecting identities (e.g. being non-white, foreigners/foreign-born and non-Swedish speakers), which is compounded by HIV status and thus limit their opportunities in the new country and too often result in an existence of exclusion.

CONCLUSION: The study shows that most of the challenges that migrants living with HIV face are related to their status as migrants rather than HIV status, which is often not known by the public or authorities. These challenges are similar, but still differ depending on social position, previous experiences, time since arrival and since diagnosis. This emphasizes the importance of both intersectional, intersectoral and multisectoral approaches to address reported issues.

BACKGROUND: Evidence suggests that migration increases vulnerability to human immunodeficiency virus (HIV) and other sexually transmitted infections (STI). However, there is limited knowledge about what has been done or needs to be done to address migrants' vulnerability in receiving countries.

OBJECTIVES: A scoping review was carried out to map the existing literature in this field, describe its characteristics, identify gaps in knowledge and determine whether a Sexual and Reproductive Health and Rights (SRHR)-perspective was applied.

METHODS: We used the Arksey and O'Malley framework and the Joanna Briggs Institute guidelines for scoping reviews and subsequent enhancements proposed by other authors. We searched three databases and grey literature to identify relevant publications.

RESULTS: A total of 1,147 records were found across the three electronic databases and compiled. Of these, only 29 papers that met the inclusion criteria were included. The review shows that research in this field is dominated by studies from the USA that mostly include behavioural interventions for HIV and HBV prevention among migrants from Latin America and Asian countries, respectively. None of the interventions integrated an SRHR perspective. The intervention effects varied across studies and measured outcomes. The observed effects on knowledge, attitudes, perceptions, behavioural intentions and skills were largely positive, but reported effects on testing and sexual risk behaviours were inconsistent.

CONCLUSIONS: There is a need for good quality research, particularly in parts of the world other than the USA that will address all STIs and specifically target the most vulnerable subgroups of migrants. Further research requires greater scope and depth, including the need to apply an SRHR perspective and incorporate biomedical and structural interventions to address the interacting causes of migrants' vulnerability to HIV/STIs.