Closing Gaps in Migrant Youth Sexual Health

A new UBC-led study finds that migrant youth in Canada are less likely to be sexually active than their Canadian-born peers—but among those who are, contraception use is declining. The findings point to systemic barriers in sexual health education and access, rather than individual behaviors, and highlight the need for culturally relevant support for newcomer adolescents.

Published in BMC Public Health, the study analyzed data from over 30,000 15- and 16-year-olds collected through the Health Behaviour in School-aged Children (HBSC) surveys from 2014, 2018 and 2022. Researchers focused on youth who were not born in Canada, comparing their sexual health behaviors to those of Canadian-born teens to identify patterns and gaps.

The study was guided by a 21-member migrant youth advisory group, whose insights helped explain the findings and shaped recommendations.

Declining condom and birth control use

Among sexually active migrant youth, researchers found a decline in contraception use. In 2022, migrant boys were more likely to report using no contraception during their last sexual encounter, with condom use dropping significantly over the eight-year period. No significant change was observed among non-migrant boys. Migrant girls were consistently less likely to use the contraceptive pill across all three survey years.

Use of dual contraception (condoms plus the pill) also fell for both migrant boys and girls in 2018 and 2022, widening the gap with non-migrant teens.

"Our advisory group noted that many teens who arrive in Canada miss school-based sex education because of when they migrate," says Dr. Daniel Ji, lead author from the University of Regina's faculty of social work and a former postdoctoral researcher at UBC. "Some of them also said contraception is stigmatized in their family's culture. In seeking sexual health services, they may face language barriers and they worry about confidentiality."

The authors also noted that the pandemic may have had a role in the trends: stay-at-home orders, reduced privacy and disrupted health care access likely contributed to the sharp declines observed in the 2022 survey.

Dr. Elizabeth Saewyc, senior author and director of UBC's Stigma and Resilience Among Vulnerable Youth Centre, said the barriers the advisory group identified can make it harder for migrant youth to get accurate information and access reliable contraception.

"Young people need comprehensive, culturally relevant and accurate sexual health education in schools, preferably occurring more than once in high school. For newcomers to Canada, who might have missed that before arriving, there should be added opportunities." She noted that free or low-cost contraceptives are available in B.C. for young people, and youth-friendly, confidential sexual health care services can help migrant youth access needed services.

Dr. Ji added, "We also recommend involving young people directly in shaping programs, to ensure services meet their needs. Young people have important suggestions for improving these trends, grounded in the realities of their lives, and we should listen to them."