Navigating sexual healthcare: a qualitative study on experiences, STI knowledge, and information sources among migrant men who have sex with men in the Netherlands.

BACKGROUND

Migrant men who have sex with men (mMSM) may face barriers in accessing sexual healthcare and information, contributing to health disparities, as they are at increased risk of exposure to sexually transmitted infections (STIs), including HIV, hepatitis B, and hepatitis C. To better understand how healthcare systems can be made more equitable and responsive to mMSM's needs, this qualitative study explored (1) mMSM's experiences with sexual healthcare in their countries of origin and in the Netherlands, (2) STI and prevention knowledge, and (3) sources of sexual health information.

METHODS

Semi-structured interviews were conducted with 15 mMSM aged 16 years and older from Eastern Europe, South/Central America, Asia, and Africa between December 2023 and April 2024. mMSM were recruited purposively by sexual health nurses at Dutch Public Health Service STI clinics in South Limburg, via snowball sampling and flyers until data saturation was reached. Interviews were transcribed verbatim and thematically analysed in ATLAS.ti using deductive and inductive coding by two independent researchers. Intercoder agreement was reached through consensus.

RESULTS

mMSM reported limited and fragmented access to sexual healthcare in their country of origin, often shaped by stigma, taboos, and limited information, rather than uniformly poor care. Awareness of common STIs, particularly HIV, was high, although depth and accuracy of knowledge varied, while knowledge of hepatitis C was minimal or absent. Most participants were aware of HIV pre-exposure prophylaxis (PrEP) and hepatitis B vaccination, although detailed knowledge of correct use and underlying conditions was often limited or fragmented. In contrast, awareness and knowledge of post-exposure prophylaxis (PEP) were limited. Main sexual health information sources included general internet search engines, sexual health professionals, and the interpersonal social network, with differences in perceived reliability and accessibility between these sources.

CONCLUSIONS

Availability of sexual healthcare alone does not ensure equitable access for mMSM; barriers such as language, trust, and information gaps persist, highlighting the need for culturally responsive, stigma-free care and targeted prevention education.