Immigrant women’s use of contraceptives and HIV testing in Sweden

This study, a part of a PhD thesis [1], concerns the knowledge and use of contraceptive counselling and HIV testing among refugee and non-refugee women [2]. The study was based on a questionnaire that women answered in their SFI course (Swedish for immigrants). The women were predominantly from Somalia, Iraq, Syria, and Afghanistan. Poor sexual and reproductive health (SRH) among immigrant women is often related to limited access, or suboptimal use of healthcare services. The main aim with the PhD thesis [1] was to improve the understanding of foreign-born women’s knowledge about and use of different services within sexual and reproductive health (SRH), e.g. contraceptive consultation and HIV testing.

Use of contraceptive counselling

  • One-third (31%) of the women reported lack of knowledge about where to turn for contraceptive counselling.
  • The majority (68%) had never attended contraceptive counselling in Sweden.
  • Contraceptive counselling was more common among women living with a partner and having children than women without.
  • Women living in Sweden for four years or less and women with no children had higher odds of reported lack of knowledge.

Cultural background affects contraceptive use

  • One-quarter of respondents perceived that their own cultural beliefs prevented them from using contraceptives. Somalia-born women showed the highest proportion (50%) stating that their culture prevents them from using contraceptives.

Self-perceived contraceptive knowledge and STD awareness

  • Almost one-third (30%) did not know how to avoid getting pregnant.
  • One-third (33%) did not know how to protect themselves against STDs (HIV/AIDS, chlamydia, gonorrhea). This related to their education level.
  • More than one-third (37%) believed that birth control pills protect against HIV/AIDS.

Knowledge of where to turn for HIV testing in Sweden

  • Just over half of the participants (56%) did not know where to get HIV tested. Women born in Afghanistan, Iraq and Syria had increased odds of lack of knowledge.
  • Women who had not undergone a health examination had higher odds of reported lack of knowledge, as compared with women who had undergone a health examination.
  • Participation in health examination was associated with knowledge about where to turn for HIV testing, which could be explained by the fact that immigrants coming to Sweden as refugees are HIV tested when attending health examination. However, despite most women having undergone health examination, it is surprising that many of them don’t know where to go for HIV testing.
  • One-third reported that they had been HIV tested.
  • More than half of the women (56%) reported that they had never been HIV tested.

References:

[1] Åkerman, E. (2019). Challenges and opportunities for sexual and reproductive healthcare services for immigrant women in Sweden. Uppsala University. http://www.diva-portal.org/smash/get/diva2:1285692/FULLTEXT01.pdf

[2] Åkerman, E., Larsson, E.C., Essén, B. & Westerling, R. (2019). A missed opportunity? Lack of knowledge about sexual and reproductive health services among immigrant women in Sweden. Sexual & Reproductive Healthcare, 19(2019), 64–70.http://www.diva-portal.org/smash/get/diva2:1285242/FULLTEXT01.pdf

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