Participants
Table 1 showed that a total of 51 international migrants in China participated in the interview. Their ages ranged from 16 to 60, with an average of 36.8 years. Their average residence time in China is 10.4 years. Most participants owned bachelor's degree or above (74.51%) followed by senior high school (19.61%) and below junior high school (3.92%). Among the interviewees, 4 (7.84%) participants had a monthly income of 5000–6000 yuan, 3 (5.88%) participants had a monthly income of 155000 yuan, 170000 yuan, and 400000 yuan respectively, and 20 (39.22%) participants had a monthly income of 10000–50000 yuan, and 24 (47.06%) had no stable income. In terms of Chinese proficiency, 15 (31.25%) participants could speak Chinese fluently, 13 (27.08%) participants could conduct daily communication in Chinese, 16 (33.33%) participants had some difficulties in using Chinese for communication, and 4 (8.33%) participants hardly used Chinese.
Table 1
Basic information of interviewees
Variables
|
Information
|
Age range
|
16–60 years
|
Age mean
|
36.8 yeas
|
Average residence time in China
|
10.4 years
|
Education
|
|
Bachelor's degree or above
|
74.51%
|
Senior high school
|
19.61%
|
Below junior high school
|
3.92%
|
Personal monthly income
|
|
5000–6000 yuan
|
7.84%
|
155000 yuan, 170000 yuan, and 400000 yuan respectively
|
5.88%
|
10000–50000 yuan
|
39.22%
|
No stable income
|
47.06%
|
Chinese proficiency
|
|
Speak Chinese fluently
|
31.25%
|
Conduct daily communication in Chinese
|
27.08%
|
Have some difficulties in using Chinese for communication
|
33.33%
|
Hardly used Chinese
|
8.33%
|
Number of interviewees
|
51
|
The vulnerability before the migration
Religious belief
Participants' religious beliefs may have an impact on their level of sex education. Through the analysis of the interview results, we found that all participants who had misunderstood or one-sided views on sexually transmitted diseases were Muslims and believed in Islam. A considerable part (80.00%) of Muslims was very resistant to sexual topics when interviewed. A participant from Mali said: "No, I'm a Muslim. I don't know (about sexual behavior)." Another participant from Pakistan said: "My religion tells me that I can't do this (sex education for the next generation). I'm a Muslim and no one tells me to do this." Under the influence of Islam, the sexual culture of Muslims was conservative, and they take a serious attitude towards sexual issues.[15] In the interview, nearly half (42.86%) of Muslims revealed that their parents and schools did not give them sexual health education, or in other words, did not give them sufficient and comprehensive sexual health education. Some (5.71%) Muslims even knew nothing about sexual behavior and its expansion knowledge (e.g., STD, measures of contraception) before marriage.
Figure 1 The vulnerability of international floating population to sexually transmitted diseases.
Regional And Political Influence
In addition to the influence of religious belief, nations also have an impact on education. For example, among the interviewees, all immigrants from Syria said that they had received sexual health education from their parents or schools, and believed that sexual health education should be given to the next generation. A Syrian immigrant said in the interview: "This (STD) has always been advertised in our country, telling us to be careful with these things. HIV is famous and everyone knows it." It can be seen that Syria fully publicizes STD through advertisements in the country, which can help prevent the occurrence of STD and reduce the prevalence of STD to a certain extent. However, immigrants from Pakistan said that they had not received relevant sexual health education and were unwilling to provide sexual health education to the next generation. They said Pakistan was traditional rather than open.
The Bondage And Openness Of Sexual Culture
Under the influence of different sexual cultures, people's attitudes towards sexual behavior were also obviously different. In the interview, most Muslims (80.00%) declared that Islam prohibits premarital sex and that their own sexual culture is more conservative than that of China. "We are Muslims. We can't have premarital sex. It's illegal." Muslims also resist commercial sexual behavior and occasional sexual intercourse. "Others behaviors (referring to commercial sexual behavior and temporary sexual partner behavior) are few. People who have those behaviors are morally wrong." A Muslim from Yemen said.
However, the cultures of various countries also have an imperceptible, far-reaching, and lasting impact on sexual culture. As Muslims, seven immigrants claimed that premarital sex was allowed in their own country, and one of them believed that China's sexual culture was more open. Immigrants from Morocco also mentioned that "they do not mind talking about premarital sex, which is different from Muslim countries." In comparison, Muslims from Muslim countries are more conservative in terms of sex.
Muslim sexual culture emphasizes sexual morality and prohibits indulgence and promiscuity. It advocates and encourages the satisfaction of sexual desire through legal marriage. Islam has promulgated various regulations, such as the prohibition of private meetings between men and women who are not close relatives. Many Muslims also mentioned that they had the custom of separating men and women since childhood. The low incidence of sexually transmitted diseases in Muslim countries maybe closely related to their conservative sexual culture.[16]
Among the interviewees, immigrants who believe in Christianity hold opposite attitudes toward sexual behavior to Muslims. They all believe that premarital sex is very normal and that commercial sex and temporary sexual partner behavior are common behaviors. Immigrants from Tanzania mentioned that they implemented polygamy. The open sexual culture should not be criticized, but it is worth noting that behind the openness, the hidden health dangers of commercial sexual behavior and temporary sexual partner behavior should not be ignored. Once the relevant and necessary health detection and prevention measures are neglected, there is a risk of the spread of sexually transmitted diseases.
The lack of sexual health education
Although almost all participants (97.96%) showed a certain understanding of sexually transmitted diseases, misunderstandings and one-sided interpretations in understanding of sexually transmitted diseases still existed. For example, STD can be transmitted through blood, body fluid and breast milk. However, some participants believed that STD would not be transmitted from mother to child, and they were not clear about whether the virus could be transmitted through mosquitoes. In addition to the above participants, a Muslim from Egypt said he had no idea what STD including HIV were. This phenomenon of misunderstanding and one-sided understanding of sexually transmitted diseases is the manifestation of the lack of knowledge related to sexually transmitted diseases. Due to lack of sufficient knowledge, people do not know the route of transmission of STD and symptoms of infectious diseases, so they cannot take effective preventive measures before infection, and cannot seek medical treatment in time at the early stage of the disease to prevent subsequent deterioration of the disease. And the lack of adequate and comprehensive sexual health education is one of the reasons for the short of such knowledge among participants.
Ages
In the interview, we found that the older the interviewees are, the earlier time they were born, and the weaker awareness of sexual health education. This may because the sex education was relatively poor at early time. Until 1993, the International Planned Parenthood Federation proposed in its research report that more extensive sexual health education for adolescents should be carried out. Take the United States and Japan for example, both of them formulated the comprehensive sex education manuals in the late 1970s and later.[17] Several sex education programs in the United States (such as Project Taking Charge and Postponing Sexual Involvement) were also launched after the 1980s.[18] It can be inferred that before the end of the 1970s, sexual health education in the world did not receive sufficient attention and promotion. Therefore, the interviewees were born in 1967–1979 may had limited sexual health education.
The Vulnerability After The Migration
More open sex culture
In the interview, a considerable number of participants (58.00%) mentioned that compared with their original countries, China's sexual culture is more open. "Our country doesn't like men and women to stay together." "We (men) can't go out with women. We'll get married if we choose someone." Immigrants from Arabia and Libya said so. These interviewees believe that in China, commercial sex and temporary sexual partner behavior are more acceptable and more likely to occur. A British immigrant said: "In China, commercial sex is better carried out (considering taxes and fees), and it is easier for people to have commercial sex in China than in Britain." In a more open social environment, the informal social control mechanism (referring to the social control implemented by conventional customs, ethics, public opinion, etc.) is reduced, the acceptance of non-marital sex is higher, and the communication barriers between men and women suddenly disappear. People's long-term nature of being suppressed and imprisoned by conservative culture and national culture is suddenly released, personal space is expanded, and personal ability to effectively manage sexual health-related risks is also challenged.[19]And the increased possibility of engaging in commercial sex and temporary sexual partner behavior will make immigrants face a higher risk of sexually transmitted diseases.[20]
Family Member Supervision
All of the interviewers mentioned that the degree of freedom in all aspects of life has increased after immigration. Nearly half (36.73%) of the immigrants reported that they had no relatives living in China, and 17 of them are now living alone. When asked about the changes in sexual behavior before and after immigration, an international student from Thailand said: "I feel free in China. In my country, my parents controlled me. but here I can go out with my boyfriend and sleep with him, so it is more convenient. I can't do it (having sex with my boyfriend) at home." After emigration, due to the geographical isolation from the original family, the immigrants are separated from the supervision of their parents (or spouses), and their personal space is expanded. The possibility of sexual behavior (including commercial sexual behavior and temporary sexual partner behavior) is also increased, thus increasing the risk of STD.
Social Isolation And Marginalization
In this study, the income of the respondents is in the upper middle level, so there maybe no marginalization of social status caused by economic problems. Due to their geographical isolation from their families and original social networks, although some respondents stated that the support of their families and friends had not changed, they did not deny that their contacts had decreased. Nearly half (38.78%) of the immigrants admit that they feel lonely and depressed because of language barriers and cultural differences. "I came to China to do business and have no real friends. When I first came to China, I didn't find this. At first, I regarded others as friends, but (later) I found that they only wanted to do business with me." One immigrant from Syria complained. Polish immigrants also mentioned, "Generally speaking, it is difficult to make friends in Japan, South Korea, and China. People (in China) are very close to each other, but we are different. Everyone calls us foreigners." It is difficult for migrants to truly integrate into society, resulting in a sense of separation from society and personal isolation, which makes this vulnerability more complicated. [21]
Suggestions For Std Prevention
In the interview, many interviewees mentioned that they were willing to give sexual health education to the next generation. An immigrant from Yemen pointed out that "this (sexual health education) is a cultural and educational issue". They believed that among the effective methods and strategies for preventing STD among international migrants, education is the first priority. "If international migrants and other people have not received education on this issue, they will really spread the disease freely. That is why it is very important to carry out comprehensive education in schools." A British also said so. He added that in school sex education, teachers should not only teach the scientific part of sex, but also teach "interpersonal communication, safety and consent between two people". In addition, teachers should also teach students to correctly use condoms and other prevention methods, and popularize other ways to spread STD (such as sharing cutting needles). Additionally, although many interviewees thought that China's medical services were relatively convenient and perfect, they still admitted that language barriers were a problem that could not be ignored in terms of medical treatment and access to information.