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      You are the first person to ask me how I’m doing sexually”: sexual and reproductive health needs and sexual behaviours among migrant people in transit through Panama

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          Abstract

          Background

          Unprecedented numbers of migrant people transiting through the Darién Gap at the Panama-Colombia border were recorded in 2021 and 2022. Data on sexual and reproductive health (SRH) needs and service provision among migrant people in transit is generally extremely sparse. This study aimed to collect personal accounts of sexual behaviours and SRH needs and access to services among migrant people in transit through Panama.

          Methods

          We conducted a rapid-assessment qualitative study using semi-structured interviews during June-July 2022. Participants were migrant people in transit at three locations across Panama: (i) at the Migrant Reception Station (MRS) in Darién province at the Panama-Colombia border, (ii) in the city of David near the Costa Rica-Panama border, and (iii) at the Costa Rica-Panama border. Migrant peoples (>18 years) were invited to participate using purposive sampling.

          Results

          Overall, 26 adult migrant people (16 men, 10 women) across the three sites participated in the study. We identified three overarching themes from the interviews: (1) increased need for SRH service provision, (2) experiences of sex, relationships, and transactional sex, and (3) vulnerability to exploitation and sexual violence. All accounts reported that no formal SRH care was present during the journey through the Gap and described as inconsistent at the MRS in Darién. Provision of gynaecological or genital examinations, laboratory testing for urinary tract or STI, and prenatal care were mentioned to be the most pressing needs. Participants reported a change in their sexual behaviour while travelling, whether a decline in sexual libido or preference towards short-term partners. Most female participants recounted constantly fearing sexual violence during the journey through the Gap and several respondents reported witnessing incidents of sexual and other forms of violence.

          Conclusion

          There are significant unmet needs regarding SRH care during the journey of migrant people transiting through the Darién Gap, at the MRS in the Darién province, and across Panama. Provision of antenatal care, rapid testing for HIV/STI, condom distribution, and care for victims of sexual violence would significantly reduce adverse SRH outcomes and improve the well-being of migrant people, even when in transit.

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          Most cited references27

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          Using thematic analysis in psychology

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            Sexual behaviour in context: a global perspective.

            Research aimed at investigating sexual behaviour and assessing interventions to improve sexual health has increased in recent decades. The resulting data, despite regional differences in quantity and quality, provide a historically unique opportunity to describe patterns of sexual behaviour and their implications for attempts to protect sexual health at the beginning of the 21st century. In this paper we present original analyses of sexual behaviour data from 59 countries for which they were available. The data show substantial diversity in sexual behaviour by region and sex. No universal trend towards earlier sexual intercourse has occurred, but the shift towards later marriage in most countries has led to an increase in premarital sex, the prevalence of which is generally higher in developed countries than in developing countries, and is higher in men than in women. Monogamy is the dominant pattern everywhere, but having had two or more sexual partners in the past year is more common in men than in women, and reported rates are higher in industrialised than in non-industrialised countries. Condom use has increased in prevalence almost everywhere, but rates remain low in many developing countries. The huge regional variation indicates mainly social and economic determinants of sexual behaviour, which have implications for intervention. Although individual behaviour change is central to improving sexual health, efforts are also needed to address the broader determinants of sexual behaviour, particularly those that relate to the social context. The evidence from behavioural interventions is that no general approach to sexual-health promotion will work everywhere and no single-component intervention will work anywhere. Comprehensive behavioural interventions are needed that take account of the social context in mounting individual-level programmes, attempt to modify social norms to support uptake and maintenance of behaviour change, and tackle the structural factors that contribute to risky sexual behaviour.
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              Defining “High-risk Sexual Behavior” in the Context of Substance Use

              Introduction: Sexual behavior is a behavior exhibited by individuals to gratify one of their basic needs, that is the sexual need. Often the way in which sexual behavior is practiced may lead to negative consequences. However, the definition of a sexual behavior as risky varies with regards to culture, gender, age, and the threshold. Objectives: This review aims to study different definitions of high-risk sexual behavior available in literature, the differences in the prevalence of various risks associated with risky sex in substance-using population as compared to general population, and eventually formulating a tentative definition of “high-risk sexual behavior” in the context of substance use. Current evidence and results of literature search as we have entered into the epidemic of human immunodeficiency virus globally, it is important clinically as well as from the public health perspective to define high-risk sexual behavior discretely helping the researchers quantify the burden and the clinicians focus on the population at risk. High-risk sexual behavior has often been discussed and studied in various studies till date. However, literature lacks a discrete definition of high-risk sexual behavior. Risky sex (or high-risk sexual behavior) has been variably defined in different studies. Majority of the definitions in the studies focus on sexually transmitted infection, especially human immunodeficiency virus. A few studies talk about unintended pregnancies or abortions. Conclusion: The association between high-risk sexual behavior and substance use has been well established. Further research is warranted to obtain a definition which has greater precision and clinical utility, and which can be integrated in preventive and promotive pursuits.
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                Author and article information

                Contributors
                Journal
                Front Reprod Health
                Front Reprod Health
                Front. Reprod. Health
                Frontiers in Reproductive Health
                Frontiers Media S.A.
                2673-3153
                2673-3153
                10 July 2023
                2023
                : 5
                : 1157622
                Affiliations
                [ 1 ]Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine , London, United Kingdom
                [ 2 ]Instituto Conmemorativo Gorgas de Estudios de la Salud , Panama City, Panama
                [ 3 ]Faculty of Medicine, University of Ottawa , Ottawa, ON, Canada
                [ 4 ]Faculty of Medicine, Universidad Interamericana de Panamá , Panama City, Panama
                [ 5 ]Faculty of Latin American and Social Studies, FLACSO , Buenos Aires, Argentina
                [ 6 ]Faculty of Anthropology, Univeristy of Connecticut , Storrs, CT, United States
                [ 7 ]National Research System of Panamá (SNI) , Panamá, Panamá
                [ 8 ]Center of Population Sciences for Health Equity, College of Nursing, Florida State University , Tallahassee, FL, United States
                Author notes

                Edited by: Marissa L. Becker, University of Manitoba, Canada

                Reviewed by: Tariku Tesfaye Bekuma, Wollega University, Ethiopia Lisa Lazarus, University of Manitoba, Canada

                [* ] Correspondence: Amanda Gabster agabster@ 123456gorgas.gob.pa
                Article
                10.3389/frph.2023.1157622
                10370347
                56448218-e579-4db3-9972-6f17c49d7273
                © 2023 Panchenko, Mayaud, Baranyi Nicholls, López González, Ordáz, Baird and Gabster.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 02 February 2023
                : 26 June 2023
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 45, Pages: 0, Words: 0
                Funding
                Funded by: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding is provided by Instituto Conmemorativo Gorgas de Estudios de la Salud, The Panama-based NGO: Community Development Network of the Americas, and the National Research System (SNI) of the National Secretariat of Science, Technology and Innovation (Panama) and the London School of Hygiene and Tropical Medicine (United Kingdom).
                The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding is provided by Instituto Conmemorativo Gorgas de Estudios de la Salud, The Panama-based NGO: Community Development Network of the Americas, and the National Research System (SNI) of the National Secretariat of Science, Technology and Innovation (Panama) and the London School of Hygiene and Tropical Medicine (United Kingdom).
                Categories
                Reproductive Health
                Original Research
                Custom metadata
                HIV and STIs

                migrant,migrant healthcare,sexual and reproductive health (srh),sexually transmitted infections (sti),hiv,sexual violence,darien,panama

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