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Sexual and reproductive health (SRH) is a human right. Young people, particularly from marginalised groups such as migrant and refugees, are vulnerable to compromised sexual and reproductive health and rights. In this study, we aimed to identify socioecological factors influencing migrant and refugee youth SRH decision-making and compare perspectives of youth with key stakeholders. Data were collected using Group Concept Mapping (GCM), a mixed-methods participatory approach. Participants included migrant and refugee young people, aged 16-26 from Western Sydney ( n  = 55), and key stakeholders comprising clinicians, service providers and researchers ( n  = 13). GCM involved participants brainstorming statements about how migrant and refugee youth make SRH decisions. Participants then sorted statements into groups based on similarity, and rated statements on importance and impact. Multidimensional scaling and hierarchical cluster analysis were used to cluster statements into concept maps that represented participants' perspectives. The resulting maps comprised six clusters representing main concepts informing decision-making. The most important clusters were 'healthy relationships' and 'safe-sex practices'. Youth rated healthy relationships more important than stakeholders did. This study reveals factors informing migrant and refugee youth's decision-making. Future policy should go beyond biomedical constructions of SRH to incorporate emotional and relational factors, which young people consider to be equally important and beneficial to their agency.

(1) Background: Access to abortion care is a crucial reproductive health right. Refugees and migrants may have restricted access to and utilisation of abortion care, associated with histories of displacement, precarious migrant and citizenship status and difficulty navigating unfamiliar host country healthcare systems. However, there is limited evidence on the abortion experiences and perspectives of refugees and migrants. Moreover, existing research has not been synthesised to identify trends informing sexual and reproductive care access among this marginalised population. This systematic review aimed to address this gap in the cumulative evidence on refugee and migrant experiences and perspectives of abortion in host countries. (2) Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the following databases for studies on refugee and migrant abortion attitudes, decision making and experiences: Embase, Medline, CINAHL, Web of Science, Sociological Abstracts, and Scopus. We also searched the grey literature on the same. Inclusion criteria specified qualitative studies involving migrant and/or refugee populations, examining their abortion experiences, attitudes or perspectives, written in English, published between January 2000 and December 2022. Two reviewers screened titles, abstracts and full-text articles, resulting in 27 articles included in the review, following consensus checks by two co-authors. The included studies were assessed for methodological quality using the Critical Appraisal Skills Programme tool. (3) Results: Abortion was stigmatised and generally considered impermissible and undesirable. However, participants discussed socioculturally determined 'exceptions' to this, positing circumstances where abortion was acceptable. There were striking differences in experiences between participants in higher-income settings and those in lower- and middle-income settings. Difficulties accessing care were ubiquitous but were heightened in lower-resource settings and among participants with precarious citizenship, financial and legal statuses. (4) Conclusions: The findings highlight the need for an international convention to guide policy and programming that acknowledges the specific abortion requirements of migrant and refugee communities, with attention to their financial, legal and social precarity.

Migrant and refugee youth (MRY) in Australia face specific experiences that inform their sexual and reproductive health and rights (SRHR). Migrant and refugee communities experience poor health outcomes and low service uptake. Additionally, youth are vulnerable to poor sexual health. This review examines the understandings and perspectives of MRY. A systematic review was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol is registered with PROSPERO: CRD42021241213. Nine databases were systematically searched. Inclusion criteria specified literature reporting on migrant and/or refugee youth perspectives and attitudes towards sexual and reproductive health; peer-reviewed qualitative, mixed-methods and/or quantitative studies or grey literature reports; records using Australian research; literature published in English between January 2000 and March 2021. Records that did not report on MRY and did not examine participant views or perspectives; were abstract-only, reviews, pamphlets, protocols, opinion pieces or letters; did not include Australian research; were published before 2000 and/or in a language other than English were excluded. Two reviewers screened titles, abstracts and full-text articles. The Mixed Method Appraisal Tool was used to assess studies' methodological quality. Thematic synthesis methods guided data extraction and analysis. Twenty-eight papers were included in the final review. Three themes were identified in MRY constructions of SRHR: (1) experiences of silence and shame; (2) understandings of and responses to SRHR risks; (3) navigation of relationships and sexual activity. Socioecological factors shaped MRY perspectives at individual, interpersonal, institutional and societal levels. Societal factors and interpersonal relationships significantly influenced decision making.