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Far away from home: Exchange students’ experiences before and after a semester abroad
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-5517-6076
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

 Background: During the school years of 2021/2022, approximately 20,000 Swedish students chose to study abroad. There are indications that Swedish exchange students exhibit sexually risky behaviour, consume alcohol to an extent that can be considered risky, and have been exposed to violence. Aim: The overall aim was to increase the knowledge about alcohol use, drug use, sexually risky behaviour, exposure to violence, and health among Swedish prospective exchange students and exchange students, and to compare these findings with students who remain on campus. Moreover, the thesis aimed to explore Swedish exchange students' experiences from a semester abroad. Methods: Study I and III are comparative cross-sectional studies, and Study II is a comparative follow-up study. Studies I to III are based on web surveys that included the instruments NorAQ, the General Health Questionnaire 12, Self-Rated Health, UngKAB, and Rosenberg's Self-Esteem Scale. Study IV was a qualitative interview study with semi-structured interviews. Results: Over half of all responding female students reported exposure to some kind of sexual violence, of which one-fifth reported severe sexual violence. Approximately one-third reported emotional violence, and one-sixth reported physical violence. Among all responding male students, one-third reported physical violence and emotional violence, and one-sixth reported severe physical violence. The prospective exchange students drank larger quantities of alcohol on the same occasion, had sex with new partners, and had sex under the influence of alcohol more often than campus students. During their semester abroad, they increased their weekly consumption of alcohol, and it became more spontaneous. They did not change their sexual behaviour, but they emphasized the use of protection against STIs. The exchange students rated their mental health as better than campus students, both before and after a semester abroad. Violence during the semester abroad was relatively uncommon, but several exchange students had taken precautions to avoid dangerous situations, mainly by being more observant about their surroundings, avoiding going out alone, and using public transport instead of taxis.Conclusions: This thesis has identified risky behaviours and occurrences of violence among all the responding students that might be associated with future ill-health; therefore, proactive interventions could be needed. Keywords: Health, mental health, exchange students, students, sexually risky behaviour, violence, alcohol use, drug use

Place, publisher, year, edition, pages
Kalmar: Linnaeus University Press, 2025. , p. 87
Series
Linnaeus University Dissertations ; 557/2025
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:lnu:diva-134678ISBN: 978-91-8082-260-2 (print)ISBN: 978-91-8082-261-9 (electronic)OAI: oai:DiVA.org:lnu-134678DiVA, id: diva2:1929364
Public defence
2025-02-14, Azur, Hus Vita, Kalmar, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2025-01-20 Created: 2025-01-20 Last updated: 2025-01-20Bibliographically approved
List of papers
1. Mental health, self-rated health, risky sexual behaviour, alcohol use, and drug use among students who intend to spend a semester abroad - a cross-sectional study
Open this publication in new window or tab >>Mental health, self-rated health, risky sexual behaviour, alcohol use, and drug use among students who intend to spend a semester abroad - a cross-sectional study
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2023 (English)In: Frontiers in Public Health, E-ISSN 2296-2565, Vol. 11, article id 1116497Article in journal (Refereed) Published
Abstract [en]

Aim: Our aim was to investigate potential differences in mental health, self-rated health, risky sexual behaviour, alcohol use, and drug use between (1) Prospective exchange students and campus students separated by sex, and (2) male and female students as a group. Method: Comparative cross-sectional design using an online survey containing the following instruments: Knowledge, Attitudes, and Sexual Behaviour in Young People in Sweden; Self-Rated Health Questionnaire; and General Health Questionnaire 12. One-hundred and fourteen prospective exchange students and 451 campus students participated in the study. Results: Male prospective exchange students rated their mental health as being better and had used cannabis more often compared with female prospective exchange students. Male prospective exchange students also rated their mental health as being better than male campus students. Female students, in general, rated their mental health as worse than male students. A larger proportion of male prospective exchange students had sex together with alcohol compared with male campus students, and a larger proportion of female prospective exchange students had sex with a new partner and drank more alcohol compared to female campus students. Conclusion: The result shows that risky alcohol use and sexually risky behaviour is prominent amongst prospective exchange students. It is possible that they will continue, and even increase their risky behaviour whilst abroad as they find themselves in a new social context, and free from influence of the rules and restrictions that they might have at home. With limited knowledge of the local culture, native language, and in an unfamiliar environment, it is possible that the risks will be enhanced and possibly decrease their health. This highlights the need for proactive interventions, conceivably with some variations in content between sexes.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023
Keywords
mental health, sexually risky behaviour, students, alcohol use, drug use, health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-123614 (URN)10.3389/fpubh.2023.1116497 (DOI)001027978600001 ()37457242 (PubMedID)2-s2.0-85164872289 (Scopus ID)
Available from: 2023-08-11 Created: 2023-08-11 Last updated: 2025-01-20Bibliographically approved
2. Swedish exchange students' alcohol use, drug use, risky sexual behaviour, mental health, and self-rated health: A follow-up study
Open this publication in new window or tab >>Swedish exchange students' alcohol use, drug use, risky sexual behaviour, mental health, and self-rated health: A follow-up study
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2023 (English)In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 40, no 3, p. 287-300Article in journal (Refereed) Published
Abstract [en]

Aims: To follow up on exchange students' alcohol use, drug use, mental health, self-rated health, and risky sexual behaviour after a semester abroad and to compare them with students who remained on campus. Methods: The study design was a follow-up study based on a previous baseline survey of 114 prospective exchange students and 451 campus students. Of the original 565 students, 48 (42.1%) prospective exchange students and 209 (43.3%) campus students responded to the follow-up. Both the baseline survey and the follow-up survey included the General Health Questionnaire 12, one single item from Self-Rated Health, and nine items from Knowledge, Attitudes and Sexual Behaviour in Young People in Sweden. Results: We found a statistically significant increase in the weekly consumption of alcohol among exchange students after their semester abroad. A larger proportion of exchange students had sex with a new partner and sex with more than three partners during their semester abroad compared to follow-up campus students. Conclusions: Our findings indicate that exchange students consume alcohol more frequently during their semester abroad and indulge in sexually risky behaviour. Exchange students' use of alcohol and sexually risky behaviour could be associated with even greater risks due to them being in an unknown environment, unfamiliar culture, and with limited support from family and friends. This highlights the need for further research on exchange students' experiences, especially concerning alcohol use and sex while abroad.

Place, publisher, year, edition, pages
Sage Publications, 2023
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-119836 (URN)10.1177/14550725231160331 (DOI)000950302900001 ()2-s2.0-85150996472 (Scopus ID)
Available from: 2023-03-17 Created: 2023-03-17 Last updated: 2025-01-20Bibliographically approved

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