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Association between psychiatric symptoms and sexual risk behaviors in immigrants and refugees from Africa living in Sweden

Yohannes, Simon (2019) Association between psychiatric symptoms and sexual risk behaviors in immigrants and refugees from Africa living in Sweden. Master Essay, University of Pittsburgh.

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Background: Research reveals that 1 in 10 refugees have Post Traumatic Stress Disorder (PTSD), and 1 in 20 have depression, but there is little understanding about the predictors of PTSD and depression in refugees and immigrants, and the association between psychiatric symptoms and sexual risk behaviors.

Methods: Immigrants and refugees from Africa residing in Sweden were interviewed between 2002-2006, and the interviews assessed immigrant and refugee’s health and quality of life. Stratified quota sampling based on the 2001 Swedish census was used to recruit a representative
sample of participants by gender and country of origin. The semi-structured interviews included valid and reliable instruments that measured depression, anxiety, PTSD, acculturation, traumatic events, and sexual health. Secondary data analysis was performed at the University of Pittsburgh. Statistical analyses consisted binomial regression to examine the predictors of psychiatric symptoms. Mann Whitney U test and Chi-square tests were performed to compare sexual risk behaviors between refugees with PTSD/depression and refugees without PTSD/depression.

Results: 420 participants completed the questionnaires. Demographic information showed that most of the participants were from Eastern Africa and a religious makeup of 51% Christians, 46% Muslims, and 3% other. Twenty percent of the sample reported symptoms in the clinical range for depression, while PTSD symptomatology and functional impairment was reported by 47% of the participants. After adjusting for age, gender, religion, country of origin, and length of residence in Sweden, a binomial regression model revealed that acculturation was a predictor for both PTSD [β = -0.094, SE = 0.036, p = 0.01] and depressive symptoms [β = -0.078, SE = 0.036, p = 0.033]. Females who reported higher levels of depressive symptoms had a greater number of lifetime sexual partners [U=3844, p= 0.001], regular sexual partners [U=3771, p=0.002] and concurrent partners [χ2 = 4.39, p = 0.027]. PTSD and depressive symptoms were not significant predictors of sexual risk behaviors for men.

Conclusion: Depressive and PTSD symptoms have a significant association with acculturation and sexual risk behaviors. Understanding these relationships can facilitate the development of public health interventions to reduce sexual risk behavior in immigrant and refugee populations.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Yohannes, Simonspy6@pitt.eduspy60000-0001-8986-2456
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairFinegold, Daviddnf@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberSteel, Jennifersteeljl@upmc.eduUNSPECIFIEDUNSPECIFIED
Date: 1 August 2019
Date Type: Submission
Number of Pages: 33
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Multidisciplinary MPH
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 29 Sep 2019 00:53
Last Modified: 29 Sep 2019 00:53

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