Development of a survey to assess sexual health knowledge, behaviour and help-seeking of Australian-born men travelling to Southeast Asia: findings from the NEXUS2 study.
Crawford G, Gray C, Phoo N, Lobo R • Sexual health • 2026
Australian-born men travelling to Southeast Asia demonstrated sexual health knowledge gaps, inconsistent protective behaviours and low awareness of prevention strategies, warranting broader survey implementation to generate national data to support targeted interventions.
Key Findings
Methods
A 62-item survey instrument was developed and validated to assess sexual health knowledge, attitudes and practices among Australian-born men traveling to Southeast Asia.
Validity testing involved face validity testing (n=8) and content validity testing (n=3).
Reliability was assessed via a test-retest (n=35) using intraclass correlation coefficients.
Overall reliability results indicated 'considerable to high agreement' in initial and repeat tests.
The instrument assessed demographics, travel characteristics, sexual health knowledge, behaviour and attitudes across 62 items.
Results
The study sample was predominantly heterosexual, tertiary educated, and employed full-time.
Total participants: n=136 Australian-born adult men who had travelled to Southeast Asia in the past 5 years.
85.9% (n=116) identified as heterosexual.
57% (n=77) were tertiary educated.
63% (n=85) were employed full-time.
Participants were recruited via a convenience sample through an online, panel-driven survey.
Results
Nearly half of participants reported having sex during their most recent trip to Southeast Asia, with less than half of those always using condoms.
48.9% (n=65/133) reported sex during their most recent trip.
Only 41.5% (n=27/65) of those who had sex always used condoms.
This indicates the majority of sexually active travellers did not consistently use condoms.
Results
One-quarter of participants reported purchasing sexual services overseas.
23.5% (n=32) of the 136 participants reported purchasing sexual services during travel to Southeast Asia.
This finding highlights a subgroup with potentially elevated STI/HIV risk.
Results
The majority of participants were unaware of both post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) for HIV prevention.
58.8% (n=77/131) were unaware of post-exposure prophylaxis (PEP).
64% (n=87/131) were unaware of pre-exposure prophylaxis (PrEP).
These findings indicate low awareness of available HIV prevention strategies among this travel population.
Results
Very few participants tested for STIs before travelling to Southeast Asia.
Only 14.5% (n=19/131) reported testing for STIs before travel.
This suggests pre-travel sexual health screening is uncommon in this population.
What This Means
This research developed and tested a survey tool to measure sexual health knowledge, behaviours, and attitudes among Australian men who travel to Southeast Asia, then used it to collect data from 136 such men. The study found that almost half of these travellers had sex during their most recent trip, but less than half of those consistently used condoms. A quarter reported buying sexual services while abroad. These patterns are relevant because Australian men travelling overseas have been identified in new HIV and sexually transmitted infection (STI) cases.
The study also found major gaps in knowledge about HIV prevention tools. More than half the participants had never heard of post-exposure prophylaxis (PEP), a medication that can reduce HIV risk after potential exposure, and nearly two-thirds were unaware of pre-exposure prophylaxis (PrEP), a daily medication that can prevent HIV infection. Only about one in seven men had been tested for STIs before travelling. Together, these findings paint a picture of inconsistent protective behaviours and limited awareness of modern prevention options.
This research suggests there is a need for targeted health education and intervention programs aimed at Australian men travelling to Southeast Asia. The validated survey tool developed in this study could be deployed on a larger, national scale to better understand the scope of this public health issue and to design more effective prevention strategies, such as pre-travel health consultations that include discussions of PrEP, PEP, and consistent condom use.
Crawford G, Gray C, Phoo N, Lobo R. (2026). Development of a survey to assess sexual health knowledge, behaviour and help-seeking of Australian-born men travelling to Southeast Asia: findings from the NEXUS2 study.. Sexual health. https://doi.org/10.1071/SH25145