Refugee and migrant men are bringing the cultural, gender and sexual norms from their countries of origin into their idea of sexual and reproductive healthcare in their countries of resettlement, researchers from the University of Adelaide have found.
The academics from the School of Public Health and Robinson Research Institute, lead by Associate Professor Zohra Lassi, analysed 36 qualitative, quantitative and mixed-method articles to identify the influences on migrant men's attitudes.
"Migration exposes people to unfamiliar gender roles and sexual views, influencing the ways they care for their sexual and reproductive health (SRH)," says PhD student Patience Castleton.
"We aimed to investigate how refugee and migrant men viewed gender and gender roles in their countries of resettlement and how they experience their SRH in their resettled countries because we know their health is often overlooked in research."
According to the review, depleted masculinity, sex and sexuality and accessing SRH care in a new country all influenced the actions of migrant and refugee men from more than 25 countries.
The analysis, which was published in the journal PLOS ONE, found there is a need for more culturally relevant and competent care and education for migrant men.
Ms Castleton, who is also the first author of the paper, said the research had found many men were concerned with the long wait times to see a doctor for SRH issues, which coupled with concerns around discrimination.
As many Western countries like those involved in the studies do not follow traditional gender roles as closely as the migrant's home countries, the men also reported struggles accepting a different power dynamic, which in turn impacted their view on their own masculinity.
"Eight studies in this review found that feelings of cultural inadequacy, helplessness and failure was a source of depleted masculinity for refugee and migrant men," Ms Castleton said.
"Refugee and migrant men who failed to build this traditional family (a wife and multiple children), were unable to prove their legitimate heteronormative sexuality for both their families in their home country and others in their new country."
Ms Castleton said many of the men also appreciated the sexual freedoms in the new countries, which gave them more opportunities to learn about SRH, often away from disapproving family members and culture.
"It was still common amongst many migrant men to hold a women's virginity in high regard, with some wanting to marry a woman with no previous sexual partner," says Ms Castleton.
"Many men from a range of Middle Eastern and African backgrounds saw woman's sexual freedom as a threat to their masculine dominance, whilst simultaneously enjoying the freedom for themselves.
"Conversely, some men's acculturation experience resulted in an increased recognition of women as equal and valued partners within sexual encounters and did not feel their masculinity was jeopardised by women's abilities to have liberal sexual experiences."
The study found men's knowledge of key SRH topics, including contraception, STIs and safe sex, differed greatly depending on their country of origin, education levels and community.
"Some studies found sound knowledge of AIDS and HIV among migrant men, whilst others found men to have limited or incorrect beliefs about their SRH illnesses," says Ms Castleton.
"SRH information, encompassing services and systems, contraception and gender and sex norms, should be incorporated into initial information packages and health testing post-migration.
"Providing this information in a culturally appropriate manner upon arrival will empower men to seek further care and information and promote open communication around SRH."
