Introduction: Limited data exists on sexual health concerns among newly-arrived refugee populations in the United States. Arizona has among the highest rates of refugee resettlement from such war-torn conflict regions as the Middle East, South-East Asia, and Sub-Saharan Africa, where myriad socio-cultural norms and taboos prevail.Women from these regions have also been exposed to sexual and gender-based violence. Limited health literacy and language barriers further compound health disparities necessitating the inclusion of refugee populations in studies examining women's sexual health, and the adaptation of validated sexual health measures to create culturally-specific and relevant assessments of sexual function. Aim: This study proposed to examine the acceptability of adapting the Decreased Sexual Desire Screener (DSDS) verbally conveyed across varied languages in a multi-ethnic sample of newly-arrived refugee women with low health literacy and limited English proficiency. Methods: The DSDS underwent a rigorous translation process into Arabic, Swahili, French, Kirundi, Somali, and Burmese utilizing community input on local dialects and cultural nuances. Four focus groups were conducted comprising 32 women to discuss elements of the DSDS and cultural interpretations of sexual desire. Community mobilization and recruitment efforts were facilitated by multi-lingual, trained interpreters. A content analysis was facilitated by NVivo 10 to code and organize themes from the transcripts. Main Outcome Measures: Comprehension and use of appropriate terminology to describe sexual desire/interest, cultural conceptualizations of sexual desire, experiences with migration/acculturation that may impact sexual health, and receptivity to seeking health care regarding sexual health concerns. Results: There were varying perspectives across ethnic groups. Emergent themes included the need for privacy/modesty, the perception of traditional cultural norms on sexuality as distinct from American sexual values, experiences of sexual pain related to Female Genital Cutting, and a desire for more education on sexual health. Conclusions: Attention to sexual health concerns should be a priority for clinicians caring for vulnerable refugee/immigrant populations. Validated sexual function measures should include cultural and linguistic adaptations to enhance the screening, counseling, education, and treatment of diverse populations.

1. Garza E, Belknap K, Nizigiyimana J, Johnson-Agbakwu C. Qualitative perspectives on sexual health and the decreased sexual desire screener (DSDS) among a multi-ethnic sample of newly-arrived refugee women. Journal of Sexual Medicine. 2014;11:214.

https://www.researchgate.net/publication/293332742_QUALITATIVE_PERSPECTIVES_ON_SEXUAL_HEALTH_AND_THE_DECREASED_SEXUAL_DESIRE_SCREENER_DSDS_AMONG_A_MULTI-ETHNIC_SAMPLE_OF_NEWLY-ARRIVED_REFUGEE_WOMEN