A meta-analysis and systematic literature review of factors associated with sexual risk-taking during international travel

Pia Svensson, Mats Sundbeck, Kristina Ingemarsdotter Persson, Martin Stafström, Per Olof Östergren, Louise Mannheimer, Anette Agardh

Research output: Contribution to journalArticlepeer-review

34 Citations (SciVal)


Background: International travel facilitates global spread of sexually transmitted infections (STI). Travellers could contribute to onward transmission of pathogens rarely encountered at home and export new strains to the destination. The aim was to systematically examine evidence regarding determinants of travel-related sexual risk-taking and identify knowledge gaps and areas for targeted interventions. Method: Articles published in peer-reviewed journals from 2000 to 2017 were screened in 6 databases and assessed for relevance against criteria. Data was extracted for factors associated with travel-related STI or proxies. Meta-analyses estimated pooled prevalence of casual sex and non-condom use. Adjusted odds ratios of predictors were pooled to generate a combined estimate. Result: Forty-nine articles qualified for inclusion. A heterogeneity test indicated variation across studies. The pooled prevalence of casual travel sex was 35% and prevalence of non-condom use 17%. Expectations of casual sex strongly predicted sex with a new partner when travelling abroad. Planning to have sex indicated condom use. Conclusion: The studies largely represented sub-groups of risk-taking populations from a European context, indicating substantial knowledge gaps. Studies investigating migrants travelling to visit friends and relatives, older travellers, and female travelers are needed. Post–travel harm reduction activities may serve as a focus for future interventions.

Original languageEnglish
Pages (from-to)65-88
JournalTravel Medicine and Infectious Disease
Early online date2018 Mar 19
Publication statusPublished - 2018 Jul

Subject classification (UKÄ)

  • Public Health, Global Health, Social Medicine and Epidemiology


  • Meta-analysis
  • Sexual risk-taking
  • Sexually transmitted infections
  • Travel


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