Echevarria Olivia Nieves, Pickering John, Crooks Valorie A, Snyder Jeremy, Milner Trudie
Department of Geography, Simon Fraser University, Burnaby, BC, Canada.
Gerontology Research Centre, Simon Fraser University, Burnaby, BC, Canada.
Trop Dis Travel Med Vaccines. 2025 May 7;11(1):11. doi: 10.1186/s40794-025-00245-4.
Sexually transmitted infections are on the rise in older populations globally, including among older travellers. International retirement migrants are older people who have retired from the workforce and travel abroad seasonally, typically during the winter months in their home countries. The transnational nature of this practice may challenge public health efforts to control the spread of sexually transmitted infection and encourage treatment. This study focuses on Yuma, Arizona, a popular destination for Canadian international retirement migrants who winter in the United States, to examine the sexual health risks associated with their seasonal travel.
Utilizing a qualitative case study approach, this research involved semi-structured interviews conducted remotely with key informants in Yuma (n = 10) who held various health care and administrative roles. Participants provided insights into sexual health risks based on their extensive interactions with Canadian seasonal migrants and their knowledge of the social dynamics within retirement communities. Interviews were transcribed verbatim, coded using NVivo software, and thematically analyzed to identify risk factors for sexually transmitted infections among Canadian international retirement migrants wintering in Yuma.
Findings revealed three main risks that may contribute to exposure to sexually transmitted infections and potential transmission: social dynamics within tight-knit retirement migrant communities that facilitate unsafe sexual practices (i.e., risky practices); barriers to accessing diagnostic services, such as costs and lack of established local care (i.e., risky care access); and challenges in following standard treatment and public health protocols due to logistical difficulties in ensuring follow-up (i.e., risky treatment decisions). Key informants noted that lifestyle choices, including the use of alcohol and drugs, can exacerbate these risks. Health care access barriers driven by travel health insurance and mobility limitations further complicate the diagnosis and treatment of sexually transmitted infections for Canadian international retirement migrants while abroad.
This study highlights the complex interplay of social behaviours and health care barriers that heighten the risk of sexually transmitted infection transmission among Canadian retirement migrants in the transnational context of Yuma. Extended diagnostic and treatment services, comprehensive sexual health education in pre- and post-travel consultations, as well as inclusive travel health insurance coverage could significantly improve the sexual health outcomes for this population.
全球老年人群中性传播感染呈上升趋势，包括老年旅行者。国际退休移民是指已从工作岗位退休并季节性出国旅行的老年人，通常是在其本国的冬季。这种行为的跨国性质可能对控制性传播感染传播及鼓励治疗的公共卫生努力构成挑战。本研究聚焦于亚利桑那州的尤马，这是加拿大国际退休移民在美国过冬的热门目的地，旨在研究与他们季节性旅行相关的性健康风险。
本研究采用定性案例研究方法，对尤马市担任各种医疗保健和行政职务的关键信息提供者（n = 10）进行远程半结构化访谈。参与者基于他们与加拿大季节性移民的广泛互动以及对退休社区内社会动态的了解，提供了有关性健康风险的见解。访谈逐字记录，使用NVivo软件编码，并进行主题分析，以确定在尤马过冬的加拿大国际退休移民中性传播感染的风险因素。
研究结果揭示了可能导致性传播感染暴露和潜在传播的三个主要风险：紧密的退休移民社区内促进不安全性行为（即危险行为）的社会动态；获取诊断服务的障碍，如费用和缺乏既定的当地护理（即危险的护理获取）；以及由于确保后续跟进存在后勤困难，在遵循标准治疗和公共卫生协议方面面临的挑战（即危险的治疗决策）。关键信息提供者指出，包括饮酒和吸毒在内的生活方式选择会加剧这些风险。旅行健康保险和行动限制导致的医疗保健获取障碍，使加拿大国际退休移民在国外时性传播感染的诊断和治疗更加复杂。
本研究强调了社会行为与医疗保健障碍之间的复杂相互作用，这种相互作用在尤马的跨国背景下增加了加拿大退休移民中性传播感染传播的风险。扩展诊断和治疗服务、在旅行前和旅行后咨询中进行全面的性健康教育，以及包容性的旅行健康保险覆盖范围，可显著改善这一人群的性健康结果。
