Challenges and opportunities for sexual and reproductive healthcare services for Thai women in Sweden

In the PhD thesis Challenges and opportunities for sexual and reproductive healthcare services for immigrant women in Sweden from 2019, the sexual and reproductive health knowledge, health-seeking behavior and needs for sexual and reproductive health information and services among Thai women living in Sweden were studied (Åkerman 2019).

The results described below are specific to immigrant women from Thailand, and there are limitations to how much this information can be generalized to other migrant groups in Sweden or in other countries.

Knowledge and use of SRH services among Thai immigrant women in Sweden

  • Slightly more than half of the Thai women had poor knowledge of where they should turn when they need sexual and reproductive healthcare services, such as contraceptive counseling, HIV and STI testing, and cervical cancer screening
  • Poor knowledge about SRH services was associated with: oldest age group, women without a partner, women who reported low trust in others and those who reported dominant bonding relationships.

Thai women’s healthcare-seeking behavior in relation to sexual and reproductive health and their views on HIV prevention

Three main themes were found:

  • Poor access to healthcare in Sweden and preferring to seek care in Thailand.
  • Partners playing a key role in women’s access to healthcare.
  • No perceived risk of HIV, but a positive attitude towards testing.

The need for SRH-related information and services among Thai women

  • The vast majority of Thai women reported a great need for information related to the healthcare system, approximately 27% had never sought care in Sweden.
  • The most needed information was about what rights Thai women had in Sweden (100%), followed by how the Swedish healthcare system functioned (97%) and where to go for HIV testing (82%).
  • Nearly two-thirds wanted to have more information about fertility and pregnancy. 
  • Among the women who had visited the healthcare in Sweden (73%), about two-third reported that they had not used an interpreter.

Thai women’s need for contraceptive counselling and use of contraception

  • Most of the Thai women (80%) had not participated in contraceptive counselling in Sweden.
  • 11% stated that they would like to have contraceptive counselling.
  • Among women using contraceptive methods, about 70% of them had bought their contraceptives in Thailand.
  • Participation in contraceptive counselling was more common among women with reported knowledge of where to turn for counselling, and women with increased years of residency in Sweden. Education level, marital status and having children were not significant predictors for using contraceptive counselling.

Factors for not being tested for HIV

  • Approximately 60% of the women were HIV tested, with 40% having been tested in Thailand. About 15% had been tested again in Sweden.
  • 7% stated that they would like to have an HIV test.
  • Women who had never been tested in Thailand had higher odds of not having been tested in Sweden compared with women who had been tested earlier in Thailand.
  • Women with lack of knowledge of where to turn for HIV testing in Sweden had higher odds of not having been HIV tested in Sweden than women with reported knowledge.

References:

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

Åkerman, E., Östergren, P-O., Essén, B., Fernbrant, C., Westerling, R. (2016). Knowledge and utilization of sexual and reproductive healthcare services among Thai immigrant women in Sweden. BMC International Health and Human Rights, 16:25.

Åkerman, E., Essén, B., Westerling, R., Larsson, E. (2016). Healthcare-seeking behaviour in relation to sexual and reproductive health among Thai-born women in Sweden: a qualitative study. Culture, Health & Sexuality, 19(2):194–207.

Åkerman, E., Larsson, E., Essén, B., Westerling, R. Utilisation of two health systems: A cross-sectional study on Swedish-Thai women’s choice of contraceptive counselling and HIV testing. Manuscript.

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