Sexual and reproductive health (SRH) remains a critical yet under-addressed issue for international students in Australia, researchers led by Budiadi Sudarto find. The pioneering study explores barriers to health equity and identifies several opportunities to improve health outcomes.
International students, who make up one-third of all higher education enrolments, are recognised as a priority population in the National Fifth Sexually Transmissible Infections Strategy and the National Ninth HIV Strategy, as people born overseas. Despite this recognition, researchers identified a significant gap in SRH resource development for international students, with uneven efforts across states and territories and a lack of national-level coordination.
To better understand the challenges, interviews with international students explored SRH perceptions and literacy as well as awareness of local resources. Background research found that students from ‘sex-negative backgrounds’ – where SRH is stigmatised – tend to have lower SRH literacy. This was linked to limited-to-no SRH education in their countries of origin.
Cultural norms from countries of origin were found to contribute to SRH stigma. Some participants shared that SRH is only considered relevant to heterosexual marriages, as sexual behaviour is only acceptable within this context. Among these, some communities also perceive STI health as unnecessary due to assumed monogamy. As a result, many students felt uncomfortable engaging with local health initiatives that openly addressed SRH.
Students also expressed concerns about confidentiality when accessing local SRH services. They expressed fear that health services would share health records with their families. Some also believed that academic professors, education institutions, government agencies, embassies and consulates also had access to health records.
Additionally, the study noted confusion among students in navigating the Australian healthcare system and identifying resources available to them.
The call for more resources was echoed by student health services, administrative staff and teaching staff. As key points of contact in the student experience, staff reported frequently receiving SRH-related enquiries but felt unequipped to respond in culturally safe ways. Concerns included offending students, eroding trust and providing inaccurate health information. Health services reported being over-capacity and unable to consistently deliver culturally safe care. In the absence of government-led initiatives, education providers felt the responsibility fell to them – citing lack of funding and skills as major barriers and creating a ‘[reliance] on stakeholder goodwill to develop SRH resources.’
In response to these findings, the paper makes several recommendations. Strong policy, sustainable funding and a clear national guideline on SRH education specific to international students will systematically enable tertiary education providers to deliver SRH initiatives that are comprehensive and culturally relevant to this specific population. Partnerships across agencies and with international student organisations are necessary in the development and delivery of such an initiative.
Resources should be developed to help students navigate the Australian healthcare system, including mapping resources available through non-Medicare accessible programs and Overseas Student Health Cover (OSHC).
Beyond translation into language, the study emphasises the importance of socio-cultural input to ensure initiatives are effective and culturally safe. Efforts should aim to normalise SRH by embedding it within general health initiatives for international students.
To improve awareness and education, the study recommends establishing multiple community touchpoints.
Both staff and student respondents believed that comprehensive online SRH information hubs would greatly enhance students’ SRH literacy. Participants also suggested that tailored online training modules would be effective in equipping both staff and students with culturally informed SRH knowledge and building confidence for in-person engagements. Online and self-paced training modules would ensure discretion and anonymity to address the lingering cultural, religious and social stigma surrounding SRH.
The study suggests peer-education models would be highly effective to address stigma and engage with students. Health promotion campaigns – incorporated into student orientation programs, for example – can generate broad awareness and link students to comprehensive information, outreach and services.
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The full paper is available under Open Access at doi.org/10.1007/s13178-025-01108-5