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International Travel as a Context for Sexual and Contraceptive Behaviors: A Qualitative Study of Young Women Traveling Outside the U.S.

Abstract

International travel is popular worldwide, yet its implications for sexual and reproductive health are not fully understood. Few studies have examined the contextual factors that shape women's sexual and contraceptive behaviors-and thus, their risk of unintended pregnancy and sexually transmitted infections (STIs)-while traveling outside their home country. In this qualitative study, female university students with recent (n = 25) or upcoming (n = 19) travel outside the U.S. completed semi-structured interviews from October 2015 to March 2017. Transcripts were analyzed for themes related to contraceptive and sexual behaviors: (1) participants' pre-travel expectations of sex; (2) the circumstances surrounding sexual encounters with men while traveling; (3) negotiation about condom and contraception use with partners; and (4) factors affecting contraceptive adherence. Participants generally expected to be abstinent during travel, citing myriad rationales that included personal values, no perceived opportunities for sex, and the nature of the trip. Some travelers had unexpected sexual encounters, involving health-protecting behaviors and risk-taking (e.g., unprotected sex, substance use). New sexual partnerships were fueled by increased attention from men, situational disinhibition, and perceived heightened intimacy. International travel brought many contraceptive considerations (adequacy of supplies, access to refrigeration, time zone differences, etc.) as well as obstacles that triggered contraceptive lapses and discontinuation. Pill users described the most challenges, while travelers using intrauterine devices expressed appreciation for their maintenance-free contraception. This study suggests complex associations between international travel and young women's sexual and reproductive health. Some travelers were more vulnerable to situational risk factors, while others may have been more insulated. We identify potential intervention opportunities via clinical services, education, and policy to reduce young women's risk of adverse sexual and reproductive health outcomes while traveling abroad. We urge greater recognition of and conversations about contraceptive lapse and unintended pregnancy as potential health risks for female travelers of reproductive age, just as clinical guidelines acknowledge travel-associated STI.

Authors+Show Affiliations

Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1301 2nd Street S., Suite 300, Minneapolis, MN, 55455, USA. mart1154@umn.edu.Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1301 2nd Street S., Suite 300, Minneapolis, MN, 55455, USA.Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1301 2nd Street S., Suite 300, Minneapolis, MN, 55455, USA.Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1301 2nd Street S., Suite 300, Minneapolis, MN, 55455, USA.Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1301 2nd Street S., Suite 300, Minneapolis, MN, 55455, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31243616

Citation

Martins, Summer L., et al. "International Travel as a Context for Sexual and Contraceptive Behaviors: a Qualitative Study of Young Women Traveling Outside the U.S." Archives of Sexual Behavior, 2019.
Martins SL, Hellerstedt WL, Bowman SB, et al. International Travel as a Context for Sexual and Contraceptive Behaviors: A Qualitative Study of Young Women Traveling Outside the U.S. Arch Sex Behav. 2019.
Martins, S. L., Hellerstedt, W. L., Bowman, S. B., Brady, S. S., & Mason, S. M. (2019). International Travel as a Context for Sexual and Contraceptive Behaviors: A Qualitative Study of Young Women Traveling Outside the U.S. Archives of Sexual Behavior, doi:10.1007/s10508-019-1400-2.
Martins SL, et al. International Travel as a Context for Sexual and Contraceptive Behaviors: a Qualitative Study of Young Women Traveling Outside the U.S. Arch Sex Behav. 2019 Jun 26; PubMed PMID: 31243616.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - International Travel as a Context for Sexual and Contraceptive Behaviors: A Qualitative Study of Young Women Traveling Outside the U.S. AU - Martins,Summer L, AU - Hellerstedt,Wendy L, AU - Bowman,Sara B, AU - Brady,Sonya S, AU - Mason,Susan M, Y1 - 2019/06/26/ PY - 2018/04/21/received PY - 2019/01/14/accepted PY - 2019/01/09/revised PY - 2019/6/28/entrez PY - 2019/6/28/pubmed PY - 2019/6/28/medline KW - Contraception KW - Sexual behavior KW - Tourism KW - Young adults JF - Archives of sexual behavior JO - Arch Sex Behav N2 - International travel is popular worldwide, yet its implications for sexual and reproductive health are not fully understood. Few studies have examined the contextual factors that shape women's sexual and contraceptive behaviors-and thus, their risk of unintended pregnancy and sexually transmitted infections (STIs)-while traveling outside their home country. In this qualitative study, female university students with recent (n = 25) or upcoming (n = 19) travel outside the U.S. completed semi-structured interviews from October 2015 to March 2017. Transcripts were analyzed for themes related to contraceptive and sexual behaviors: (1) participants' pre-travel expectations of sex; (2) the circumstances surrounding sexual encounters with men while traveling; (3) negotiation about condom and contraception use with partners; and (4) factors affecting contraceptive adherence. Participants generally expected to be abstinent during travel, citing myriad rationales that included personal values, no perceived opportunities for sex, and the nature of the trip. Some travelers had unexpected sexual encounters, involving health-protecting behaviors and risk-taking (e.g., unprotected sex, substance use). New sexual partnerships were fueled by increased attention from men, situational disinhibition, and perceived heightened intimacy. International travel brought many contraceptive considerations (adequacy of supplies, access to refrigeration, time zone differences, etc.) as well as obstacles that triggered contraceptive lapses and discontinuation. Pill users described the most challenges, while travelers using intrauterine devices expressed appreciation for their maintenance-free contraception. This study suggests complex associations between international travel and young women's sexual and reproductive health. Some travelers were more vulnerable to situational risk factors, while others may have been more insulated. We identify potential intervention opportunities via clinical services, education, and policy to reduce young women's risk of adverse sexual and reproductive health outcomes while traveling abroad. We urge greater recognition of and conversations about contraceptive lapse and unintended pregnancy as potential health risks for female travelers of reproductive age, just as clinical guidelines acknowledge travel-associated STI. SN - 1573-2800 UR - https://www.unboundmedicine.com/medline/citation/31243616/International_Travel_as_a_Context_for_Sexual_and_Contraceptive_Behaviors:_A_Qualitative_Study_of_Young_Women_Traveling_Outside_the_U_S_ L2 - https://doi.org/10.1007/s10508-019-1400-2 DB - PRIME DP - Unbound Medicine ER -