Sexuality Research and Social Policy

, Volume 15, Issue 4, pp 398–408 | Cite as

Engaging Migrant and Refugee Young People with Sexual Health Care: Does Generation Matter More Than Culture?

  • Jessica R. BotfieldEmail author
  • Christy E. Newman
  • Anthony B. Zwi


Young people from migrant and refugee backgrounds in Australia are recognised as under-utilising mainstream sexual and reproductive health care. A qualitative study was undertaken in Sydney, Australia, to explore the complexities and opportunities for engaging young people from migrant and refugee backgrounds with sexual and reproductive health information and care. Several rounds of interviews were undertaken with 27 migrant and refugee young people aged 16–24 years. These included an initial semi-structured interview (n = 27) and a follow-up and/or walking interview with a sub-set of participants (n = 9 and n = 15 respectively). A theme of ‘generational difference’ recurred throughout the interviews. Particular ways of talking about age-related differences, including the ‘young generation’ and ‘older generations’, appeared to be deployed as a mechanism for explaining a perceived disjunction between service providers and young people. This group, from a very diverse range of cultural and linguistic backgrounds, appeared to be more similar than different when talking about sexual health. They saw themselves as generationally distinct, and commonly positioned ‘older people’ as judgemental and less accepting in relation to sexual health. Migrant and refugee young people may not be fully engaged with, or benefitting from, sexual and reproductive health services, despite a number of service options being available. It is likely that their perceptions and previous experiences, as well as stated preferences for services and service providers, would affect their willingness to engage with services. To enable information and services to better reach young people across the many cultural and linguistic groups living in contemporary Australia, attention must be paid to ensuring they feel included as a member of a ‘young generation’, and ensuring services are inclusive and welcoming.


Cultural diversity Young people Sexual and reproductive health Generations Health services Australia 



We are grateful for the contributions of the young people interviewed, who so willingly shared their views and experiences, as well as for the young people who contributed as part of the Youth Advisory Group convened for the study. Thanks also to the co-investigators (Dr. Alison Rutherford, Dr. Christopher Carmody, Dr. Catriona Ooi, Dr. Melissa Kang, Dr. Mitchell Smith, Dr. Deborah Bateson, Mr. Brendan Crozier and Ms. Katherine Bennett) and partner organisations (High St Youth Health Service, Family Planning NSW, NSW Refugee Health Service, South Western Sydney Sexual Health Service, Sydney Sexual Health Centre, and Western Sydney Sexual Health Centre) who contributed to this research. Lastly, we acknowledge UNSW Arts and Social Sciences who contributed some funding towards the fieldwork for this research, as well as the support of an Australian Government Research Training Program Scholarship.

Compliance with Ethical Standards

Conflict of Interest

Author 1 is a doctoral candidate at UNSW Sydney and an employee of the Family Planning NSW Research Centre. Family Planning NSW is a partner organisation for this research. Authors 2 and 3 declare no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. Australian Bureau of Statistics. (2017). 2016 Census: Multicultural. Retrieved from
  2. Bearinger, L. H., Sieving, R. E., Ferguson, J., & Sharma, V. (2007). Global perspectives on the sexual and reproductive health of adolescents: Patterns, prevention, and potential. Lancet, 369(9568), 1220–1231.CrossRefGoogle Scholar
  3. Berne, L. A., Patton, W., Milton, J., Hunt, L. Y. A., Wright, S., Peppard, J., & Dodd, J. (2000). A qualitative assessment of Australian parents’ perceptions of sexuality education and communication. Journal of Sex Education and Therapy, 25(2–3), 161–168.CrossRefGoogle Scholar
  4. Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293–302.CrossRefGoogle Scholar
  5. Booth, M. L., Bernard, D., Quine, S., Kang, M. S., Usherwood, T., Alperstein, G., & Bennett, D. L. (2004). Access to health care among Australian adolescents young people’s perspectives and their sociodemographic distribution. The Journal of Adolescent Health, 34, 97–103.CrossRefGoogle Scholar
  6. Botfield, J. R., Newman, C. E., & Zwi, A. B. (2015). Young people from culturally diverse backgrounds and their use of services for sexual and reproductive health needs: A structured scoping review. Sexual Health, 13(1), 1–9.Google Scholar
  7. Botfield, J. R., Newman, C. E., & Zwi, A. B. (2017). Drawing them in: Professional perspectives on the complexities of engaging ‘culturally diverse’ young people with sexual and reproductive health promotion and care in Sydney, Australia. Culture, Health & Sexuality, 19(4), 438–452.CrossRefGoogle Scholar
  8. Botfield, J. R., Zwi, A. B., & Newman, C. E. (2016). Young migrants and sexual and reproductive health care. In F. Thomas (Ed.), Handbook of migration and health (pp. 438–458). Cheltenham: Edward Elgar Publishing.CrossRefGoogle Scholar
  9. Bradley, E. H., Curry, L. A., & Devers, K. J. (2007). Qualitative data analysis for health services research: Developing taxonomy, themes, and theory. Health Services Research, 42(4), 1758–1772.CrossRefGoogle Scholar
  10. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.CrossRefGoogle Scholar
  11. Bryman, A. (2016). Social research methods (5th ed.). Oxford: Oxford University Press.Google Scholar
  12. Charmaraman, L., & McKamey, C. (2011). Urban early adolescent narratives on sexuality: Accidental and intentional influences of family, peers, and the media. Sexuality Research & Social Policy, 8(4), 253–266.CrossRefGoogle Scholar
  13. Chown, P., Kang, M., Sanci, L., Newnham, V., & Bennett, D. L. (2008). Adolescent health: Enhancing the skills of general practitioners in caring for young people from culturally diverse backgrounds, GP Resource Kit 2nd Edition. In. Sydney: NSW Centre for the Advancement of Adolescent Health and Transcultural Mental Health Centre.Google Scholar
  14. Dadich, A., Jarrett, C., Sanci, L., Kang, M., & Bennett, D. (2013). The promise of primary health reform for youth health. Journal of Paediatrics and Child Health, 49, 887–890.CrossRefGoogle Scholar
  15. Davis, K. (2008). Intersectionality as buzzword: A sociology of science perspective on what makes a feminist theory successful. Feminist Theory, 9(1), 67–85.CrossRefGoogle Scholar
  16. Department of Human Services. (1998). Youth assessment of mainstream health services. Victoria: Department of Human Services.Google Scholar
  17. Dubbin, L. A., Chang, J. S., & Shim, J. K. (2013). Cultural health capital and the interactional dynamics of patient-centered care. Social Science & Medicine, 93(10), 1–16.Google Scholar
  18. Edmunds, J., & Turner, B. S. (2002). Generations, culture and society. Buckingham: Open University Press.Google Scholar
  19. Evans, J., & Jones, P. (2011). The walking interview: Methodology, mobility and place. Applied Geography, 31, 849e858.CrossRefGoogle Scholar
  20. Foster, K. (2013). Generation and discourse in working life stories. The British Journal of Sociology, 64(2), 195–215.CrossRefGoogle Scholar
  21. Garcia, C. M., Eisenberg, M. E., Frerich, E. A., Lechner, K. E., & Lust, K. (2012). Conducting go-along interviews to understand context and promote health. Qualitative Health Research, 22(10), 1395–1403.CrossRefGoogle Scholar
  22. Hach, M. (2012). Common threads: The sexual and reproductive health experiences of immigrant and refugee women in Australia. Melbourne: Multicultural Centre for Women’s Health.Google Scholar
  23. Hankivsky, O., & Cormier, R. (2009). Intersectionality: Moving women’s health research and policy forward. In. Vancouver: Women’s Health Research Network.Google Scholar
  24. Health, N. S. W. (2011). Refugee health plan 2011–2016. North Sydney: Ministry of Health, NSW.Google Scholar
  25. Health, N., & Medical Research Council. (2006). Cultural competency in health: A guide for policy, partnerships and participation. National Health and Medical Research Council: Canberra.Google Scholar
  26. Henderson, S., & Kendall, E. (2011). Culturally and linguistically diverse peoples’ knowledge of accessibility and utilisation of health services: Exploring the need for improvement in health service delivery. Australian Journal of Primary Health, 17(2), 195–201.CrossRefGoogle Scholar
  27. Iqbal, N., Joyce, A., Russo, A., & Earnest, J. (2012). Resettlement experiences of Afghan Hazara female adolescents: A case study from Melbourne. International Journal of Population Research: Australia.Google Scholar
  28. Lamb, C. F., & Smith, M. (2002). Problems refugees face when accessing health services. NSW Public Health Bulletin, 13(7), 161–163.CrossRefGoogle Scholar
  29. Liamputtong, P. (2009). Qualitative research methods (3rd ed.). South Melbourne: Oxford.Google Scholar
  30. Madden, E. F. (2017). Healthcare workers mobilising cultural health capital to assist socially marginalised patients. Health Sociology Review, 1–15. Scholar
  31. Manderson, L., Kelaher, M., Woelz-Stirling, N., Kaplan, J., & Greene, K. (2002). Sex, contraception and contradiction among young Filipinas in Australia. Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, 4(4), 381–391.CrossRefGoogle Scholar
  32. Mannheim, K. (1997 [1952]). The problem of generations. London: Routledge.Google Scholar
  33. Mason, J. (2002). Qualitative researching (2nd ed.). London: Sage Publications.Google Scholar
  34. McDaniel, S. A. (2004). Generationing gender: Justice and the division of welfare. Journal of Aging Studies, 18, 27–44.CrossRefGoogle Scholar
  35. McMichael, C. (2008). Promoting sexual health amongst resettled youth with refugee backgrounds. In. Melbourne: Refugee Health Research Centre.Google Scholar
  36. McMichael, C., & Gifford, S. (2009). It is good to know now...before it’s too late: Promoting sexual health literacy amongst resettled young people with refugee backgrounds. Sexuality and Culture, 13(4), 218–236.CrossRefGoogle Scholar
  37. Mitchell, A., Patrick, K., Heywood, W., Blackman, P., & Pitts, M. (2014). 5th National Survey of Australian Secondary Students and Sexual Health 2013. In. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University.Google Scholar
  38. National Health and Medical Research Council, Australian Research Council, & Australian Vice-Chancellors’ Committee. (2007 (Updated May 2015)). National Statement on Ethical Conduct in Human Research 2007 (Updated May 2015). Retrieved from Canberra.Google Scholar
  39. Neale, J. (2016). Iterative categorization (IC): A systematic technique for analysing qualitative data. Addiction, 111, 1096–1106.CrossRefGoogle Scholar
  40. Newman, C. E., Persson, A., Paquette, D. M., & Kidd, M. R. (2013). The new cultural politics of the waiting room: Straight men, gay-friendly clinics and ‘inclusive’ HIV care. Sexuality Research & Social Policy, 10(2), 87–96. Scholar
  41. Ngum Chi Watts, M. C., Liamputtong, P., & Carolan, M. (2014). Contraception knowledge and attitudes: Truths and myths among African Australian teenage mothers in Greater Melbourne, Australia. Journal of Clinical Nursing, 23(15–16), 2131–2141.CrossRefGoogle Scholar
  42. Pariera, K. L., & Brody, E. (2017). Talk more about it: Emerging adults’ attitudes about how and when parents should talk about sex. Sexuality Research and Social Policy. CrossRefGoogle Scholar
  43. Patton, M. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks: Sage Publications.Google Scholar
  44. Poljski, C. (2011). On your own: Sexual and reproductive health of female international students in Australia. Melbourne: Multicultural Centre for Women’s Health.Google Scholar
  45. QSR International. (2012). NVivo Qualitative Data Analysis Software: Version 10. Melbourne: QSR International Pty Ltd.Google Scholar
  46. Ransome, P. (2013). Ethics and values in social research. London: Palgrave Macmillan.CrossRefGoogle Scholar
  47. Rawson, H., & Liamputtong, P. (2009). Influence of traditional Vietnamese culture on the utilisation of mainstream health services for sexual health issues by second-generation Vietnamese Australian young women. Sexual Health, 6(1), 75–81.CrossRefGoogle Scholar
  48. Rawson, H., & Liamputtong, P. (2010). Culture and sex education: The acquisition of sexual knowledge for a group of Vietnamese Australian young women. Ethnicity & Health, 15(4), 343–364.CrossRefGoogle Scholar
  49. Reeders, D. (2011). Responding to diversity: Meeting the sexual and reproductive health needs of international students. In: Melbourne: Centre for Culture, Ethnicity & Health.Google Scholar
  50. Rogers, C., & Earnest, J. (2014). A cross-generational study of contraception and reproductive health among Sudanese and Eritrean women in Brisbane, Australia. Health Care for Women International, 35(3), 334–356.CrossRefGoogle Scholar
  51. Rose, N. (1996). Governing ‘advanced’ liberal democracies. In N. B. Rose & A. T. Osborne (Eds.), Foucault and political reason. London: UCL Press.Google Scholar
  52. Shim, J. K. (2010). Cultural health capital: A theoretical approach to understanding health care interactions and the dynamics of unequal treatment. Journal of Health and Social Behavior, 51(1), 1–15.CrossRefGoogle Scholar
  53. South Eastern Sydney Local Health District. (2011). Implementation plan for the NSW refugee health plan 2011–2016. Sydney: South Eastern Sydney Local Health District.Google Scholar
  54. Tylee, A., Haller, D. M., Graham, T., Churchill, R., & Sanci, L. A. (2007). Youth-friendly primary-care services: How are we doing and what more needs to be done? Lancet, 369, 1565–1573.CrossRefGoogle Scholar
  55. Ussher, J. M., Rhyder-Obid, M., Perz, J., Rae, M., Wong, T. W. K., & Newman, P. (2012). Purity, privacy and procreation: Constructions and experiences of sexual and reproductive health in Assyrian and Karen women living in Australia. Sexuality and Culture, 16, 467–485.CrossRefGoogle Scholar
  56. Vincent, J. A. (2005). Understanding generations: Political economy and culture in an ageing society. The British Journal of Sociology, 56(4), 579–599.CrossRefGoogle Scholar
  57. White, J. (2013). Thinking generations. The British Journal of Sociology, 64(2), 216–247.CrossRefGoogle Scholar
  58. White, R., & Wyn, J. (2013). Youth and society (3rd ed.). South Melbourne: Oxford University Press.Google Scholar
  59. World Health Organization. (2002). Adolescent friendly health services: An agenda for change. In. Geneva: World Health Organization.Google Scholar
  60. Wray, A., Ussher, J. M., & Perz, J. (2014). Constructions and experiences of sexual health among young, heterosexual, unmarried Muslim women immigrants in Australia. Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, 16(1), 76–89.CrossRefGoogle Scholar
  61. Wyn, J., & White, R. (2015). Complex worlds, complex identities: Complexity in youth studies. In D. B. Woodman & A. (Eds.), Youth cultures, transitions, and generations: Bridging the gap in youth research (pp. 28–41). Palgrave Macmillan UK: United Kingdom.CrossRefGoogle Scholar
  62. Wyn, J., & Woodman, D. (2006). Generation, youth and social change in Australia. Journal of Youth Studies, 9(5), 495–514.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre for Social Research in HealthUNSW SydneyKensingtonAustralia
  2. 2.Health, Rights and Development (HEARD@UNSW), School of Social SciencesUNSW SydneyKensingtonAustralia
  3. 3.Family Planning NSWAshfieldAustralia
  4. 4.KensingtonAustralia

Personalised recommendations