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Introduction: Evidence suggests that migrants are at a higher risk of poor sexual health compared to non-migrants. However, this vulnerability may vary depending on their socio-demographic backgrounds and experiences. This study aimed to describe the prevalence of poor self-rated sexual health, its distribution, and associated risk factors among migrants in Sweden.

Methods: This study is a secondary analysis of the 2018 Migrants’ Sexual and Reproductive Health and Rights (MSRHR-2018) survey, which included a total of 1,118 migrants enrolled in language programmes. Data were analysed with descriptive, bivariate, and multivariable regression analyses.

Results: About 19% of participants reported poor self-rated sexual health. The latter was associated with older (>44 years) age (PR:1.83; 95% CI:1.08, 3.10), low educational attainment (PR: 1.80; 95% CI: 1.04, 3.11), repeated difficulty in making ends meet (PR: 1.51; 95% CI:1.01, 2.26), being not at all or not particularly open about one’s sexual orientation (PR: 1.62; 95% CI: 1.06, 2.49), lifetime experience of discrimination (PR: 1.61; 95% CI: 1.09, 2.39), and refraining from seeking sexual and reproductive health (SRH) services despite felt needs (PR: 1.87; 95% CI: 1.22, 2.85) remained associated with poor self-rated sexual health.

Conclusion: This study highlights the prevalence of poor self-rated sexual health among migrants, while revealing significant disparities across specific subgroups that warrant targeted attention. These findings can inform policy makers, programme managers, and civil society actors in designing targeted policies and interventions for migrant subgroups at an increased risk of poor sexual health, such as middle-aged and elderly migrants, the least educated, and those who do not fully conform to social expectations on gender identity/sexual orientation. To improve sexual and reproductive health outcomes, it is essential to identify and address the barriers that hinder migrants’ access to relevant health services.