Developing culturally responsive sexual health interventions: recommendations from Middle Eastern and North African diaspora youth in Ontario, Canada.

INTRODUCTION

Sex and sexual health practices of Middle Eastern and North African (MENA) youth in Canada are under-researched, even as the community grows rapidly due to high immigration rates. Through a community-based research approach, we examined access to sexual health services among MENA youth living in Ontario, Canada, and identified interventions to strengthen uptake of sexual health services.

METHODS

Fifty-six MENA youth were recruited through purposive and snowball sampling. Participants completed a brief sociodemographic survey and joined subgroups across five sexual and gender identity categories. Each group participated in two sequential dialogical focus groups, for a total of 14 sessions. This design supported relationship-building, iterative reflection and progressively deeper discussion. A final mixed focus group reconvened 12 participants from the earlier groups to refine intervention recommendations. Data were analyzed using collaborative codebook thematic analysis, with collaborative coding and negotiated interpretation among academic and peer researchers supporting analytic credibility.

RESULTS

Youth provided recommendations for behavioural, structural and biomedical interventions that reflected their community needs. Intervention suggestions common to all groups included culturally relevant and language-specific educational programs, online interactive resources leveraging social media, mentorship programs to facilitate community connection, and health navigation tools to strengthen sexual health access and service use. Interventions unique to specific subgroups were also offered. For example, trans women newcomers recommended anti-transphobia training with language interpreters, while gay and bisexual men recommended cost-free PrEP access.

DISCUSSION: Youth-driven interventions hold significant promise for strengthening the HIV and sexual health response among MENA youth in Canada. The knowledge generated by and with youth is especially relevant for community-based health organizations, healthcare practitioners and policymakers.