Acculturation, Sexuality and Sexual Health of Indian Migrant Men Living in Australia

Abstract

Background Ethnicity and culture have an impact on sexual attitudes and behaviours of individuals and communities. Immigrants from different ethnic groups differ in sexual values, and culturally prescribed attitudes and behaviours have been found to contribute to sexual health inequalities among immigrant populations. Research has also confirmed the importance of examining the relationship between sexuality and the culture change process (acculturation). Indians belong to the world’s second most populous country and constitute one of the largest immigrant communities in Australia, the USA, UK and Canada. In 2011-12, India was Australia’s largest source country of migrants. Yet there is a paucity of scientific information about the effects of acculturation on sexuality and sexual health among Indian immigrants and most of what we know is based on research that has a number of serious conceptual and methodological shortcomings. The present study addressed this knowledge gap by exploring the psychosocial and cultural dimensions of sexuality and sexual health among a community-based sample of Indian men living in Australia. Unlike much of the previous research, which conceptualised and measured acculturation as a unilinear (assimilation) and unidimensional (behavioural) phenomenon, it adopted a bilinear, multidimensional model of acculturation. Aims The present study had three broad aims: • To explore sexual perceptions, attitudes and behaviours of Indian immigrant men living in Australia. • To explore the help-seeking attitudes of Indian immigrant men for sexual health • To examine the effects of acculturation on sexuality of Indian immigrant men living in a multicultural society (Australia). Method The project used a sequential, mixed method design. In Stage 1, qualitative data were collected from 21 participants in five focus groups. Findings from this stage were analysed both in their own right and in order to identify topics for further investigation. The group discussions were tape-recorded and transcribed and a thematic content analysis was performed. In Stage 2, 278 Indian men completed an online survey that used a 100-item questionnaire. It included a number of validated tools for measuring multidimensionality of acculturation, sexual attitudes and safe sex behaviour. The scales were assessed for their psychometric properties using the present study sample and were found to be comparable with previous findings. The survey data were analysed using non-parametric tests, where necessary, and the findings were presented in the form of descriptive and analytical statistics. Results The present study sample can be considered representative of Indian men in the general Australian population. A differential pattern of acculturation was found in the present study, with more men holding on to Indian values even though they tend to be bicultural in their behaviour and self-identity. A moderate (not too liberal or too conservative) pattern of permissive sexual attitudes was observed. Indian men’s belief in cultural values, relationship status and whether they masturbate or not were found to be significant predictors of permissive sexual attitudes. A view that sex is not only an important part of a person’s life but is also a unifying phenomenon between partners emerged from both focus group and survey data. A large proportion of Indian men expressed favourable/liberal attitudes towards masturbation and reported that they have masturbated at some point in their life. Using hands and tummy-down were the most common methods and erotic visual materials and self-thoughts (fantasising imagination) were the common stimulants for masturbation. The most frequently reported reasons for masturbating were to gain pleasure and to relax and relieve stress. About two-thirds of men who continue to masturbate reported one of three positive feelings (satisfying, healthy or attractive). Permissive sexual attitudes were the strongest predictor of positive feelings about masturbation. Indian men, irrespective of their relationship status, tended to engage in safe sex practice primarily by avoiding risky behaviours. While many were aware of HIV/AIDS, their knowledge of other common sexually transmissible infections (STIs) was limited. Data from both stages of the present study demonstrated that medical doctors (both general practitioners and specialists) were the main source of information and help for Indian men in regard to their sexual health. Conclusion The present investigation, which is first of its kind to be conducted among Indians, has established a baseline of scientific evidence to guide future research. The fluid nature of both sexuality and culture poses a considerable challenge to the scientific study of cultural effects on sexuality among any population. Even greater complexity exists in relation to Indians, who have experienced long periods of conflicting cultural influences on sexuality and whose social structure comprises a highly differentiated class and caste system. In an era of rapid economic and technological growth and modernisation, another challenge to socio-psychological studies on sexuality is the need to separate the effects of globalisation from those of acculturation. The findings also have a number of important implications for policy and for clinical practice in relation to the sexual health of immigrants in Australia. There could be considerable benefit, for instance, in developing a rapid values-assessment tool that would allow busy health professionals to look beyond a patient/client’s external behaviour or self-identity in order to facilitate holistic treatment of sexual problems. Limited knowledge about common sexually transmissible infections in Australia among Indian men has significant implications for policy changes around immigrants’ sexual health in Australia.