Development of a survey to assess sexual health knowledge, behaviour and help-seeking of Australian-born men travelling to Southeast Asia: findings from the NEXUS2 study

Background Australian men travelling overseas to Southeast Asia for work or leisure are reflected in new HIV and STI notifications. However, behavioural, social and environmental data are limited. This study developed a survey to assess sexual health knowledge, attitudes and practices among Australian-born men traveling to Southeast Asia, and presents findings. Methods A 62-item instrument was developed to assess demographics, travel characteristics, sexual health knowledge, behaviour and attitudes. Validity testing involved face (n = 8) and content (n = 3) testing. Reliability was assessed via a test-retest (n = 35) using intraclass correlation coefficients. A convenience sample of Australian-born adult men who had travelled to Southeast Asia in the past 5 years completed the online, panel-driven survey. Results Overall, reliability results indicated considerable to high agreement in initial and repeat tests. Participants (n = 136) were predominantly heterosexual (n = 116, 85.9%), more than half were tertiary educated (n = 77, 57%) and employed full-time (n = 85, 63%). Nearly half (n = 65/133, 48.9%) reported sex during their most recent trip, with less than half always using condoms (n = 27/65, 41.5%). One-quarter (n = 32, 23.5%) purchased sexual services overseas. Most were unaware of post- (n = 77/131, 58.8%) and pre-exposure prophylaxis (n = 87/131, 64%). Just over one in 10 (n = 19/131, 14.5%) tested for STIs before travel. Conclusions Participants demonstrated sexual health knowledge gaps, inconsistent protective behaviours and low awareness of prevention strategies. Findings warrant broader survey implementation to generate national data to support targeted interventions.