Pathogens without borders: Ecological determinants of sexual risk-taking behaviors among international travelers across the life course

Abstract

Purpose: Drawing insights from the ecological theory, the purpose of this paper is to explore social determinants related to pathways to high-risk sexual behaviors of international travelers across their life span. Design/methodology/approach: Data were collected from 45 international travelers in Houston, a critical transit point frequented by international visitors. Findings: Overall, several ecological settings (individuals, interpersonal, institutional and contextual) related to two typologies of international travelers (risk takers vs non-risk takers) and their inclination to engage in high-risk sexual practices in an international or/and local context were identified. Research limitations/implications: This research calls for the need to assess high-risk sexual behaviors from the ecological perspective to better understand the dynamics of disease transmission among frequent international travelers from diverse backgrounds/life styles and age cohorts. Practical implications: Prevention and treatment programs developed for at-risk international travelers should target both distal and proximal social factors that predispose travelers to vulnerable situations. To build a reliable health surveillance network, policy makers, health practitioners and educators must focus not only on individual-level determinants but also on other ecological determinants that branch out beyond the personal level (e.g. interpersonal, institutional and contextual levels). Multi-level formal and informal social networks can be developed to promote a global social climate and environment that encourage safe sex and safety precautions. Social implications: To raise awareness, the public must be constantly reminded that outbreaks of potentially health hazards can lead to unpredictable morbidity/mortality and security risks that place a burden on our nation’s economic growth, emergency responsiveness and homeland security infrastructure. Originality/value: The study is one of very few to address international travelers’ health risk, while abroad, from an ecological lens across the life course.