{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T02:08:15Z","timestamp":1789006095147,"version":"build-2803163510"},"reference-count":37,"publisher":"CSIRO Publishing","issue":"5","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study evaluates the perceived impact and needed enhancement of a co-designed digital sexual and reproductive health (SRH) tool (\u2018the Hub\u2019) developed to address SRH literacy gaps among international students (IS) in New South Wales, Australia. Despite Australia\u2019s large IS population and recognition of SRH as a fundamental human right, many report limited exposure to SRH information and face barriers to navigating health systems and accessing SRH services in host countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A mixed-methods evaluation was conducted comprising an online survey (August\u2013October 2024; N\u00a0=\u00a0129) and a focus group discussion (FGD) with professionals working with IS (N\u00a0=\u00a011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Survey findings indicate high acceptability and perceived usefulness of the Hub, with over 80% of participants rating content, including on the Australian health system, as high quality and most endorsing its design, tone, and usability. Although IS knowledge of HIV prevention and STI treatment was generally strong, gaps persisted regarding asymptomatic STIs, contraceptive limitations, and health system navigation. Notably, despite high awareness and favourable peer norms toward condom use and STI testing, testing uptake remained low: fewer than one in five sexually active IS reported STI (17.8%) or HIV (19.4%) testing in the previous 12\u00a0months. Qualitative FGD findings highlighted support for broader promotion strategies, including pre-arrival and campus-based dissemination, alongside needed enhancements to service navigation and cost transparency for SRH services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall, the Hub demonstrates feasibility and relevance as a digital intervention, though improved promotion and stronger linkage between knowledge and service uptake are essential to maximise public health impact.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh26028","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:21:20Z","timestamp":1789003280000},"source":"Crossref","is-referenced-by-count":0,"title":["Moving beyond sexual and reproductive health knowledge: an evaluation of a co-designed digital engagement tool to promote sexual and reproductive health among international students in New South Wales, Australia"],"prefix":"10.1071","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9211-1813","authenticated-orcid":true,"given":"Sylvester","family":"Okeke","sequence":"first","affiliation":[{"name":"ACentre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia."},{"name":"BHealth, Rights and Development, School of Social Sciences, UNSW Sydney, Sydney, NSW, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliza","family":"Basheer","sequence":"additional","affiliation":[{"name":"CCentre of Population Health, Ministry of Health, NSW Health, Sydney, NSW, Australia."},{"name":"DPostgraduate Program in Sexual and Reproductive Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rochelle","family":"Avasalu","sequence":"additional","affiliation":[{"name":"CCentre of Population Health, Ministry of Health, NSW Health, Sydney, NSW, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Slattery","sequence":"additional","affiliation":[{"name":"CCentre of Population Health, Ministry of Health, NSW Health, Sydney, NSW, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Meggitt","sequence":"additional","affiliation":[{"name":"EUNSW Health Promotion Unit, UNSW Sydney, Sydney, NSW, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0995-5789","authenticated-orcid":true,"given":"Limin","family":"Mao","sequence":"additional","affiliation":[{"name":"ACentre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"2026090921211765200_R1","unstructured":"Australian Government Department of Education PRISMS. International student numbers by country, by state and territory. Australian Government Department of Education; 2023. Available at https:\/\/www.education.gov.au\/international-education-data-and-research\/international-student-numbers-country-state-and-territory"},{"key":"2026090921211765200_R2","doi-asserted-by":"crossref","unstructured":"UNESCO, UNFPA, UNICEF, WHO. International technical guidance on sexuality education: an evidence-informed approach. UNESCO; 2018. Available at https:\/\/doi.org\/10.54675\/UQRM6395","DOI":"10.54675\/UQRM6395"},{"issue":"10","key":"2026090921211765200_R3","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1080\/13691058.2024.2410834","article-title":"University students\u2019 access and use of sexual and reproductive health services in Australia.","volume":"27","author":"Mundie","year":"2025","journal-title":"Cult Health Sex"},{"issue":"1","key":"2026090921211765200_R4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1071\/SH21073","article-title":"A systematic review of international students\u2019 sexual health knowledge, behaviours, and attitudes.","volume":"19","author":"Lim","year":"2022","journal-title":"Sex Health"},{"issue":"1","key":"2026090921211765200_R5","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-10445-0","article-title":"How perceived Australian sexual norms shape sexual practices of East Asian and sub-Saharan African international students in Sydney.","volume":"21","author":"Okeke","year":"2021","journal-title":"BMC Public Health"},{"issue":"1","key":"2026090921211765200_R6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0115435","article-title":"Sexual and reproductive health knowledge, contraception uptake, and factors associated with unmet need for modern contraception among adolescent female sex workers in China.","volume":"10","author":"Lim","year":"2015","journal-title":"PLoS ONE"},{"issue":"1","key":"2026090921211765200_R7","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15418-z","article-title":"STI and HIV testing: examining factors that influence uptake among domestic Australian-born, domestic overseas-born and international tertiary students studying in Australia.","volume":"23","author":"Engstrom","year":"2023","journal-title":"BMC Public Health"},{"issue":"3","key":"2026090921211765200_R8","doi-asserted-by":"publisher","first-page":"243.e9","DOI":"10.1016\/j.jadohealth.2004.08.032","article-title":"HIV and sexual health knowledge and sexual experience among Australian-born and overseas-born students in Sydney.","volume":"37","author":"Song","year":"2005","journal-title":"J Adolesc Health"},{"issue":"10","key":"2026090921211765200_R9","first-page":"817","article-title":"Female international students and sexual health - a qualitative study into knowledge, beliefs and attitudes.","volume":"40","author":"Burchard","year":"2011","journal-title":"Aust Fam Physician"},{"key":"2026090921211765200_R10","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1080\/14681811.2018.1506915","article-title":"Sexual and reproductive health education attitudes and experience in India: how much support is there for comprehensive sex education? Findings from an Internet survey.","volume":"19","author":"O\u2019Sullivan","year":"2019","journal-title":"Sex Educ"},{"issue":"3","key":"2026090921211765200_R11","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1071\/SH19209","article-title":"International students\u2019 views on sexual health: a qualitative study at an Australian university.","volume":"17","author":"Parker","year":"2020","journal-title":"Sex Health"},{"issue":"5","key":"2026090921211765200_R12","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1093\/her\/cyae014","article-title":"\u2018You are making it sound like you are talking to a child\u2019: exploring community sentiment on developing and disseminating tailored sexual health education resources for migrants.","volume":"39","author":"Gray","year":"2024","journal-title":"Health Educ Res"},{"issue":"5","key":"2026090921211765200_R13","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph13050485","article-title":"Migrant sexual health help-seeking and experiences of stigmatization and discrimination in Perth, Western Australia: exploring barriers and enablers.","volume":"13","author":"Agu","year":"2016","journal-title":"Int J Environ Res Public Health"},{"key":"2026090921211765200_R14","unstructured":"King J, McManus J, Kwon A, Gray R, McGregor S. HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2023. Sydney: Kirby Institute for Infection and Immunity in Society, UNSW; 2023. Available at https:\/\/www.kirby.unsw.edu.au\/research\/reports\/asr2023"},{"key":"2026090921211765200_R15","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101661","article-title":"HIV prevalence ratio of international migrants compared to their native-born counterparts: a systematic review and meta-analysis.","volume":"53","author":"Santoso","year":"2022","journal-title":"eClinicalMedicine"},{"issue":"4","key":"2026090921211765200_R16","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daab212","article-title":"Sexual health in a new cultural context: a resource for international students in regional Australia.","volume":"38","author":"MacPhail","year":"2023","journal-title":"Health Promot Int"},{"issue":"10","key":"2026090921211765200_R17","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19106264","article-title":"\u201cCompared to COVID, HIV Is Nothing\u201d: exploring how onshore East Asian and Sub-Saharan African international students in Sydney navigate COVID-19 versus BBVs\/STIs risk spectrum.","volume":"19","author":"Okeke","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"2026090921211765200_R18","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-021-00777-z","article-title":"\u201cI always prefer to withdraw than use a condom\u201d: contextualising condomless sex among East Asian and sub-Saharan African international students in Sydney.","volume":"80","author":"Okeke","year":"2022","journal-title":"Arch Public Health"},{"issue":"1","key":"2026090921211765200_R19","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14512-y","article-title":"\u201cIt was protected, except, it wasn\u2019t [with] a condom\u201d: a mixed-methods study of BBVs\/STIs protective practices among International University Students in Sydney, Australia.","volume":"22","author":"Okeke","year":"2022","journal-title":"BMC Public Health"},{"key":"2026090921211765200_R20","unstructured":"Adam PCG, Ketsuwan I, de Wit JBF. Trends in sexual health-related behaviours among young adults in Australia: results from the repeat Debrief Survey on the short-term and longer-term effects of COVID-19. Sydney, Australia: Centre for Social Research in Health, UNSW Sydney; 2024."},{"key":"2026090921211765200_R21","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1080\/14780887.2020.1769238","article-title":"\u201cOne Size Fits All? What counts as quality practice in (Reflexive) thematic analysis?","volume":"18","author":"Braun","year":"2021","journal-title":"Qual Res Psychol"},{"issue":"4","key":"2026090921211765200_R22","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis.","volume":"11","author":"Braun","year":"2019","journal-title":"Qual Res Sport Exer Health"},{"issue":"1","key":"2026090921211765200_R23","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-08673-0","article-title":"Applying technology to promote sexual and reproductive health and prevent gender based violence for adolescents in low and middle-income countries: digital health strategies synthesis from an umbrella review.","volume":"22","author":"Huang","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"2026090921211765200_R24","unstructured":"Slattery C, Stratten M, Mao L, Corio B, Sapthari G, Okeke S, Prihaswan P, De Vries S. Consultations for the International Student Health Hub. Summary of key findings. International Student Health Hub, NSW Health. Technical Report. 2020"},{"issue":"1","key":"2026090921211765200_R25","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-08818-y","article-title":"A systematic review of sexual and reproductive health interventions for young people in humanitarian and lower-and-middle-income country settings","volume":"20","author":"Desrosiers","year":"2020","journal-title":"BMC Public Health"},{"issue":"1","key":"2026090921211765200_R26","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-3572","article-title":"Sexual health programs for Latinx adolescents: a meta-analysis.","volume":"146","author":"Evans","year":"2020","journal-title":"Pediatrics"},{"issue":"4","key":"2026090921211765200_R27","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1177\/15248399231162379","article-title":"Evaluation of a brief online sexual health program for adolescents: a randomized controlled trial.","volume":"25","author":"McCrimmon","year":"2024","journal-title":"Health Promot Pract"},{"issue":"12","key":"2026090921211765200_R28","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.70212","article-title":"Efficacy of digital health interventions used for adolescent\u2019s sexual health: an umbrella review.","volume":"7","author":"Borji-Navan","year":"2024","journal-title":"Health Sci Rep"},{"issue":"5","key":"2026090921211765200_R29","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18052555","article-title":"Sex education in the spotlight: what is working? Systematic review.","volume":"18","author":"Lameiras-Fern\u00e1ndez","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"2026090921211765200_R30","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1071\/SH21055","article-title":"STI and HIV knowledge and testing: a comparison of domestic Australian-born, domestic overseas-born and international university students in Australia.","volume":"18","author":"Engstrom","year":"2021","journal-title":"Sex Health"},{"issue":"5","key":"2026090921211765200_R31","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1071\/SH21101","article-title":"STI testing among young people attending music festivals in New South Wales, Australia: exploring the client segmentation concept in the \u2018Down to Test\u2019 program.","volume":"18","author":"Janssen","year":"2021","journal-title":"Sex Health"},{"issue":"11","key":"2026090921211765200_R32","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.74788","article-title":"Understanding comprehensive sexuality education: a worldwide narrative review.","volume":"16","author":"Albert Sekhar","year":"2024","journal-title":"Cureus"},{"issue":"1","key":"2026090921211765200_R33","doi-asserted-by":"publisher","DOI":"10.1080\/26410397.2024.2372165","article-title":"Nimble adaptations to sexual and reproductive health service provision to adolescents and young people in the early phase of the COVID-19 pandemic.","volume":"32","author":"Ali","year":"2024","journal-title":"Sex Reprod Health Matters"},{"key":"2026090921211765200_R34","doi-asserted-by":"publisher","DOI":"10.2196\/44861","article-title":"What adolescents say in text messages to motivate peer networks to access health care and sexually transmitted infection testing: qualitative thematic analysis.","volume":"26","author":"Lightfoot","year":"2024","journal-title":"J Med Internet Res"},{"issue":"1","key":"2026090921211765200_R35","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-023-02854-7","article-title":"Just in case: undergraduate students identifying and mitigating barriers to their sexual and reproductive health needs.","volume":"24","author":"Olson","year":"2024","journal-title":"BMC Womens Health"},{"issue":"2","key":"2026090921211765200_R36","doi-asserted-by":"publisher","first-page":"150","DOI":"10.32674\/jis.v4i2.475","article-title":"Ensuring rights: improving access to sexual and reproductive health services for female international students in Australia.","volume":"4","author":"Poljski","year":"2014","journal-title":"J Int Stud"},{"key":"2026090921211765200_R37","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s13178-025-01108-5","article-title":"Exploring barriers and opportunities for tertiary education providers to deliver sexual and reproductive health education to international students: a qualitative study.","volume":"23","author":"Sudarto","year":"2026","journal-title":"Sex Res Soc Policy"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/doi\/10.1071\/SH26028\/1952423\/sh26028.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/doi\/10.1071\/SH26028\/1952423\/sh26028.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:21:23Z","timestamp":1789003283000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/23\/5\/SH26028\/275881\/Moving-beyond-sexual-and-reproductive-health"}},"subtitle":[],"editor":[{"given":"Gemma","family":"Crawford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":37,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10,20]]}},"URL":"https:\/\/doi.org\/10.1071\/sh26028","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"value":"1448-5028","type":"print"},{"value":"1449-8987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"article-number":"SH26028"}}