Fiona MacKenzie-Ede

Introduction: Refugees face many barriers when arriving in a new country, and these barriers are especially felt by women, who often travel alone or with children. These barriers create a situation where some women turn to sex work, either voluntarily or involuntarily. Both refugees and sex workers face adversities related to their mental health and well-being, however little research has examined the intersections between both identities outside of STI incidence and violence. Objective: This systematic literature review aimed to explore mental health and overall well-being of women refugees who engage in sex work. Themes were extracted to better understand experiences to inform clinical and community practice. Methods: A systematic literature review was conducted using PsycInfo, CINAHL, Scopus, Web of Science, PubMed, Google Scholar, ProQuest, and Medline, as well as grey literature for articles published between 2013 and 2023. The JBI Critical Appraisal Checklist for Qualitative Research was used to evaluate the quality of the primary research articles. 11 articles were included in the final synthesis. Results: The five themes included Fear, Mental/Psychological Health, Social Well-being, Economic/Financial Well-being, and Spiritual Struggles. These themes were interconnected to shape the experiences of these women within their circumstances. Engaging in sex work as a refugee, particularly in instances of sex trafficking, created significant challenges in all aspects of well-being, and the circumstances related to being a refugee often increased vulnerabilities to become involved in sex work for survival. Conclusion: These results suggest the need for policies, community programs, and clinical practice protocols to address the unique needs of women refugees to mitigate factors drawing them to sex work, and better support those who are currently involved in it.

Background: Healthcare systems worldwide face the significant challenge of meeting the complex healthcare needs of refugee older adults. These individuals encounter numerous barriers at micro, meso, and macro levels in accessing and using healthcare in their host or resettled countries. Beyond these barriers, understanding their specific healthcare needs, healthcare-seeking behaviors, health practices, and the facilitators that enhance their access to and utilization of both formal and informal healthcare is crucial for improving their health outcomes. Objective: Our scoping review aims to capture the scope and range of evidence on refugee older adults’ healthcare needs, healthcare-seeking behaviors, health practices, and facilitators and barriers to access to and utilization of formal and informal healthcare. Methods: The Joanna Briggs Institute (JBI) methodology for scoping reviews along with the PRISMA-ScR framework will guide this scoping review. Literature written in English and published between 2011 and 2024 will be selected if they focused on refugee older adults who are 55 years of age and older. Scholarly literature will be searched using CINAHL, SocINDEX, Academic Search Complete, PsycINFO and MEDLINE, and gray literature will be captured by searching ProQuest’s Dissertations and Theses Global, Google, and Google Scholar. The extracted data will be synthesized, and narratively presented and supported by tables designed to align with the scoping review’s objective. Implications: The results of this scoping review will be used to offer actionable insights for healthcare providers, policymakers, and researchers. By mapping the existing landscape and identifying gaps, we also hope to inform the development of more inclusive and responsive healthcare models that address the specific needs of refugee older adults.