Diversity & Equality in Health and Care Open Access

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�??I had to cry�??: exploring sexual health with young separated asylum seekers in East London

Shamser Sinha, Shruti Uppal, Anthony Pryce

In the UK, asylum seekers are at the forefront of political and media discourse, with research describing how they are perceived as imminent threats to the nation and its citizens. Research also questions whether this discourse, the asylum andimmigration framework, and discriminatory practice result in young asylum seekers being exposed to health risks and inequalities in standards of service delivery and outcome. Particular concerns have been raised about sexual health and sexual exploitation for those young asylum seekers separated from parents, who, if under social services care, are categorised as ‘unaccompanied’. There is a paucity of studies exploring these issues and suggesting ways in which the situation might be improved. Our research seeks to help redress this. We carried out in-depth interviews and small focus groups with 17 young unaccompanied asylum seekers, and in-depth interviews with 10 professionals in the London borough of ackney. Culture, gender and religion appeared to combine with relationships and sexual activities in complex ways. Young people described more opportunities to meet potential partners in the UK than before migration. Young people experienced varying pre-migration access to sex education, but almost none in the UK, which may contribute to increased risks. Insecurities over material needs, and uncertainty over immigration status appeared to push some towards sexual exploitation. Multiple barriers to accessing healthcare were also reported by professionals and young people. Based on these results we argue that professionals are challenged with reforming institutional practices to achieve positive sexual health in the face of existing inequalities. This may require measures such as facilitating registration with general practitioners; working practices supporting widening access; interprofessional working to share information on sexual exploitation; and the integration of both an understanding of culture and religion as contextual into practice and sex education into English language courses in colleges.