The challenges of promoting sexual health in a multicultural community 

Sexual education for multicultural people is particularly important because sexual and reproductive health is perceived as a very intimate and private matter. In our experience, in many cultures, concepts related to sexual and reproductive health may even be unfamiliar in one’s own native language. How can they then be discussed in a foreign language?
Laura Usenius, Marianne Merikukka, Nea Röhmö, Oona Takala, Jaana Tilli
Laura Usenius

The challenges of raising the issue of sexual health 

Discussing sexual health in a foreign language can be particularly difficult considering the sensitivity of the topic. People who have moved from abroad may find it difficult to trust the Finnish health system and understand its principles of operation. In many other countries, almost anyone, such as a priest or a psychiatrist, can be considered an expert in health promotion. The Terkku project aims to bring information about non-communicable diseases to people from different cultural backgrounds by developing models for outreach work. Its particularly important to ensure that the issues are presented in an understandable and culturally sensitive way in the project. Harmful attitudes towards sexual health exist in many cultures. The use of contraception can be experienced as a lack of love and trust. There may also be a perception that abortion is safer than, for example, the use of combined contraceptive pills. In addition, contraception is seen only in terms of preventing pregnancy, with no consideration given to preventing sexually transmitted diseases (STDs).

Taking care of your sexual health is worth it 

Prevention of human papillomavirus (HPV) infection is part of sexual health. Around 80% of people are exposed to the virus in their lifetime, but only a small proportion become ill. Condom use prevents around 70% of infections, but does not provide complete protection, as the virus can spread not only from the genitals but also from the skin around the genitals. In addition to condom use, you can protect your sexual health by not smoking. Finland and Sweden have the lowest smoking rates in Europe, while Greece and Bulgaria have the highest smoking rates. Smoking lowers immune defences, which can make you more vulnerable to cancer. There are cultural differences in smoking worldwide which influence cancer statistics, among other factors. The papillomavirus can cause prolonged inflammation, which can lead to cancer or its precursors. Papillomaviruses can cause a number of different cancers, but the most common is cervical cancer in women and tonsil cancer in men.   

Vaccination as part of sexual health promotion 

The most effective way to prevent cancers is to give HPV vaccines to people who have not yet been exposed to the papillomavirus. Vaccines are most effective when given before sexual activity begins. In Finland, HPV vaccines are available free of charge to all children aged 10-12 years as part of the vaccination programme. Vaccination is important regardless of gender, culture, or sexual orientation. In addition to vaccines, pap smears and HPV screenings organised for all women aged 30-65 are an important part of cervical cancer prevention in Finland. The aim of these screenings is to detect possible precancerous lesions or gynaecological infections at an early stage. Cultural factors and trust in healthcare influence the uptake of screening and vaccination. HPV vaccines are strongly associated with sexuality and with vaccinations starting at the age of 10, children’s’ parents don’t sufficiently understand their purpose.

Outreach work to raise awareness 

In the Terkku project, our aim was to raise awareness of cervical cancer and related screening among clients from different cultures. We organised a health event that also included other aspects of sexual health, such as contraceptive counselling and information on the HPV vaccine. The health event was organised in cooperation with the Multicultural Association of Satakunta and was held remotely online to ensure the lowest possible threshold for participation. The possibility of anonymity was important to ensure that everyone could participate despite cultural and social pressures. We received material from the Finnish Cancer Registry to support our work. During the project, it was particularly important to ensure that all the information used was explained and in an understandable format. This was supported by translating the materials not only into Finnish but also into Russian and English. Attention was paid to talking about things by using their real names, but in a culturally sensitive way. In addition, support was provided by another group of students in the Terkku project from different cultures. 


The authors are final year nursing and public health nursing students from the Diakonia University of Applied Sciences. The blog post was written as part of a public health nursing curriculum development task, which was carried out as part of the Terkku project. 

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