The results are presented in three main categories: Personal experience of prevention efforts prior to travelling abroad, attitudes towards prevention efforts prior to travelling abroad, as well as prevention efforts wished for by young adults.
Personal experience of prevention efforts prior to travelling abroad
Very few of the young adults had personal experience of having encountered any prevention efforts prior to travelling abroad, and had not expected it either. Most of them had not received any oral or written information or any form of intervention.
A: “From the trip I was on, there was absolutely nothing / … /”.
B: “No, I can only agree / … / nothing specific on that particular trip”.
C: “Nah, you never receive any info before you travel abroad”.
D: “I don’t think so either, I’ve travelled a few times as well, both with friends and recently now with my girlfriend and I don’t remember receiving any information”. (Interview no. 4 with four men, 25, 25, 28 and 22-years-old)
Since many trips today are booked without any personal contact with travel agencies or other actors who would be able to provide information aimed at travellers, the young adults never expected to get information.
“I don’t know who would provide the information because you just buy a ticket and then you go”. (Interview no. 4, Male, age 28)
Through television commercials and brochures, many were aware of the risk of getting hepatitis abroad since the hepatitis vaccination was recommended for many destinations. However, only a few encountered any prevention efforts against other STIs.
“The only thing I noticed was not actually to do with sexuality, it was just this, that you should get vaccinated against hepatitis. / … /”. (Interview no. 7, Male, age 20)
Those who had encountered any efforts were essentially those who themselves actively sought information by contacting, for example, a vaccination clinic or youth clinic.
Many felt that there was no obvious place where young adults 20–29-years-old could be reached by preventive measures in a natural way. Several felt that it was problematic that they, and others in their age group, did not know where they should go if they wanted information or to get tested for STIs.
“That’s a bit difficult too, to find places. Before, you went to the youth clinic”. (Interview no. 7, Male, 23 years)
“Now, it’s been quite a while since I got myself tested for anything, but that’s because I don’t know where I should go”. (Interview no. 15, Female, 25 years)
Attitudes towards prevention efforts prior to travelling abroad
The majority of respondents were in favour of prevention efforts against HIV/STIs before travelling abroad and wished for more. Most felt that the information was needed, and they were generally positive about outreach efforts.
“There are always new diseases, so you always need to get new information / … / More information is positive”. (Interview no. 11, Female, 26 years)
One man was negative towards getting information about HIV/STIs before the trip. He was not adverse to information and education about HIV/STIs but felt that it would be more natural if schools addressed this issue.
“It should feel a bit like a parent who is trying to educate someone in some way. / … / If I were to get knowledge somewhere, then I would have liked to have had it during my sex education class at school rather than getting it in the mail from an airline company”. (Interview no. 7, Male, age 20)
Prevention efforts wished for by young adults
Many wished that they had encountered prevention efforts against HIV/STIs in the form of short reminders, links to where they could find information or through opportunities for discussion. They also called for better basic knowledge in schools and emphasised the importance of being involved in the learning process.
The young adults felt that the information could be beneficial if it was present where travellers sought general advice during preparation for their trips, such as in travel magazines, medical information service, on the reservation page or the travel agency. It was suggested that a link could be included with the reservation so that the traveller him/herself could read further. They wanted information about various STIs as well as about how healthcare worked in different countries. Many were positive about the opportunity to have a dialogue about the topic in order to increase their knowledge and understanding.
“I think about social media in general, not just stand and shout out the message, but being able to discuss it. Maybe there’s a Facebook page you can find more information or to talk to someone, email or have a chat or something like that”. (Interview no. 10, Female, 25 years)
They argued that by having information about HIV/STIs available and visible in the community, it would be like a reminder for young adults to take their own initiative to seek more information or contact healthcare services. The first step is to attract attention, which can then lead the individual further, from thought to a change in behaviour.
For personal contact, it was desirable to obtain information from a person with whom they could identify with, in an environment they felt comfortable in. The person should be authoritative, competent, serious and straightforward. A tour guide or a person who works at the resort was one example of someone who could provide such information.
“Those who are actually there, know how it is; they’ve seen how young people are. They know what can happen, those who are there”. (Interview no. 4, Male, 22 years)
Even conversations and knowledge from friends were emphasised. Talking from personal experience, which created a strong sense of identification, could offset lack of knowledge about the subject.
“I think it’s easier to listen to someone your own age. Well, I don’t know, it’s both maybe. If you talk to someone who is older… you probably have a little more trust in someone who is more experienced, so to speak. But, I think it is easier to communicate with someone your own age”. (Interview no. 16, Male, 25 years)
Many called for more frequent, comprehensive and better targeted information during school, which was perceived by many as a natural place to reach young people. Given that many young adults travel abroad after graduation, the last year of high school was viewed as an appropriate time to provide information on HIV/STIs.
“Yes, at the end (of high school) when everyone asks, ‘what will you do afterwards?’ , you think that you want to go abroad. If you get some information then, you can take it to heart”. (Interview no. 8, Female, 21 years)
Because individuals are receptive to information at different times, many felt that it needed to be conveyed continuously. Reminders and recurring information were important ways to get their attention and allow for the information to be absorbed. One negative aspect of the information was if it was too exhaustive and took too long to read or absorb.
“Also, if you’ve gotten the information in school when you were in eighth grade, a lot has happened since then. Both with the information they received then and also with you. How receptive were you then?” (Interview no. 10, Female, 25 years)
“It should be like a tweet, that much you could handle…” (Interview no. 14, Male, 26 years)
There was also a wish that the information would focus on the positive aspects of sexuality and benefits of protecting oneself and staying healthy, and thereby change attitudes towards condoms among young people.
“It is always about condoms, ‘use a condom to not get sick’. Instead, you could promote it more and make ads ‘have some fun, use a condom’. Kind of make it a fun thing instead of doing it as a shield that you put on…”. (Interview no. 7, Male, age 20)