Relation of Psychosocial Factors to Diverse Behaviors and Attitudes among Somali Refugees

Refugee studies have examined both resilience and adverse outcomes, but no research has examined how different outcomes co-occur or are distinct, and the social-contextual factors that give rise to these diverse outcomes. 

The current study begins to address this gap by using latent profile analysis to examine the ways in which delinquency, gang involvement, civic engagement, political engagement, and openness to violent extremism cluster among Somali refugees. We then use multivariable regression analyses to examine how adversity (e.g., discrimination, trauma, and marginalization) is associated with the identified latent classes. Data were collected from 374 Somali refugee young adults (Mage = 21.30 years, SD = 2.90, range 18-30, 38% female) from 4 different North American communities. 

Participants completed a structured survey assessing their experiences of adversity, delinquent and/or violent attitudes and behaviors (e.g., attitudes toward violent extremism, participation in delinquent behaviors, involvement in gangs), and positive outcomes (e.g., civic and political engagement). 

Our findings indicate that participants fall into 5 distinct groups, and that social-contextual and individual factors are uniquely related to those groups. Specifically, strong social bonds seem to be associated with positive outcomes. 

These findings point to the need to further examine both positive and negative outcomes, paying special attention to social-contextual factors.

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By:  Ellis BH, Abdi SM, Lazarevic V, White MT, Lincoln AK, Stern JE, Horgan JG.

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Violence & Reproductive Health Preceding Flight from War: Accounts from Somali Born Women in Sweden

Political violence and war are push factors for migration and social determinants of health among migrants. Somali migration to Sweden has increased threefold since 2004, and now comprises refugees with more than 20 years of war experiences. Health is influenced by earlier life experiences with adverse sexual and reproductive health, violence, and mental distress being linked. Adverse pregnancy outcomes are reported among Somali born refugees in high-income countries. The aim of this study was to explore experiences and perceptions on war, violence, and reproductive health before migration among Somali born women in Sweden.

Qualitative semi-structured individual interviews were conducted with 17 Somali born refugee women of fertile age living in Sweden. Thematic analysis was applied.

Before migration, widespread war-related violence in the community had created fear, separation, and interruption in daily life in Somalia, and power based restrictions limited access to reproductive health services. The lack of justice and support for women exposed to non-partner sexual violence or intimate partner violence reinforced the risk of shame, stigmatization, and silence. Social networks, stoicism, and faith constituted survival strategies in the context of war.

Several factors reinforced non-disclosure of violence exposure among the Somali born women before migration. Therefore, violence-related illness might be overlooked in the health care system. Survival strategies shaped by war contain resources for resilience and enhancement of well-being and sexual and reproductive health and rights in receiving countries after migration.

“…they [the militia men] abused me. […] They think that if someone happens to see the genital organs of a married woman, the woman has to be stoned – stoned to death. […] It was just after the delivery I escaped. I had recently given birth.” (Woman 5)

“This with rape, I think is something new in Somalia. So, the general public or the people have not learned how to support and what kind of help is available. There are different women’s organizations helping. Not many know they exist. And before the war I don’t think there has been such an organization helping women that have been exposed to violence […] So, I think it will be that you keep it to yourself, in the small family.” (Woman 17)

Table 2

Themes and sub-themes on war, violence and SRH in Somalia

Theme	Subthemes
Violence is everywhere in war-torn Somalia	Controlled by the fear of violence
	Interrupted life and scattered families
	Childbearing – natural but hazardous
The silence of sexual and intimate partner violence	Rape happens, but who can intervene?
	Intimate partner violence is a family issue
Stoic women keep life together	We cannot dwell on what cannot be changed
	We have learnt to be strong

Full article at: http://goo.gl/LEWzzu

By: Ulrika Byrskog, Pia Olsson, Birgitta Essén, and Marie Klingberg Allvin

School of Education, Health and Social Studies, Dalarna University, S-791 88 Falun, Sweden

Department of Women’s and Children’s Health, Uppsala University, Akademiska sjukhuset, S-751 85 Uppsala, Sweden

Centre for Clinical Research, Nissers väg 3, S-791 82 Falun, Sweden

Ulrika Byrskog, Email: es.ud@ybu.

   

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HIV Prevalence Correlates with High-Risk Sexual Behavior in Ethiopia's Regions

HIV prevalence varies between 0.9 and 6.5% in Ethiopia’s eleven regions. Little has been published examining the reasons for this variation.

We evaluated the relationship between HIV prevalence by region and a range of risk factors in the 2005 and 2011 Ethiopian Demographic Health Surveys. Pearson’s correlation was used to assess the relationship between HIV prevalence and each variable.

There was a strong association between HIV prevalence and three markers of sexual risk: mean lifetime number of partners (men: r = 0.87; P < 0.001; women: r = 0.60; P = 0.05); reporting sex with a non-married, non-cohabiting partner (men: r = 0.92; P < 0.001, women r = 0.93; P < 0.001); and premarital sex. Condom usage and HIV testing were positively associated with HIV prevalence, while the prevalence of circumcision, polygamy, age at sexual debut and male migration were not associated with HIV prevalence.

Variation in sexual behavior may contribute to the large variations in HIV prevalence by region in Ethiopia. Population-level interventions to reduce risky sexual behavior in high HIV incidence regions should be considered.

Below:  15–49 year old HIV prevalence (%) by region as determined by Ethiopian Demographic Health Surveys 2005 and 2011

Below:  Histograms of the reported number of lifetime sexual partners by region in men aged 15–59 years (EDHS 2011)

Purchase full article at: http://goo.gl/Lhr2RA

By:

Chris R. Kenyon, Achilleas Tsoumanis

HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium

Chris R. Kenyon

Department of Medicine, University of Cape Town, Cape Town, South Africa

Ilan Steven Schwartz

Department of Medical Microbiology, Faculty of Health Sciences, College of Medicine, University of Manitoba, Winnipeg, Canada

Ilan Steven Schwartz

Department of Epidemiology and Social Medicine, Faculty of Health Sciences, University of Antwerp, Belgium

  

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“A Somali Girl is Muslim and Does Not Have Premarital Sex. Is Vaccination Really Necessary?” A Qualitative Study into the Perceptions of Somali Women in the Netherlands About the Prevention of Cervical Cancer

Below:  The health belief model

In this study, we have identified perceived barriers to the use of preventive measures across three major themes: (1) Somali women and preventive healthcare; (2) Language, knowledge, and negotiating decisions; and (3) Sexual standards, culture, and religion. Many issues have been identified across these themes, e.g., distrust of the Dutch health care system or being embarrassed to get Pap smears due to Female Genital Mutilation (FGM) and having a Dutch, male practitioner; or a perceived low susceptibility to HPV and cancer because of the religious norms that prohibit sex before marriage.

Current measures in the Netherlands to prevent women from developing cervical cancer hardly reach Somali women because these women perceive these kinds of preventative measures as not personally relevant. Dutch education strategies about cervical cancer deviate from ways of exchanging information within the Somali community.

Teachers can provide culturally sensitive information to young Somali women in schools. For Somali mothers, oral education (e.g., poetry or theater) about the Dutch health care system and men’s roles in HPV transmission may be useful.

An intersectional approach, grounded in the Health Belief Model (HBM), is recommended to promote equal access to preventive health care for Somali women.

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