Young Latinas and abortion: the role of cultural factors, reproductive behavior, and alternative roles to motherhood.

Latina women have often been portrayed as holding strong traditional family values leading to a greater propensity for rejection of contraception and abortion. Increasingly, the literature has consistently shown that Latina women use contraception effectively when available; however, much less is known about the prevalence of abortion and the factors related to its use in this population. In this article we examine Latinas' use of abortion and identify factors affecting its use among 1,207 ever-pregnant Latina women age 14-24 recruited at two federally-funded family planning clinics in the Los Angeles metropolitan area. Only a small proportion of the young women in our sample (7.5%) had ever had an induced abortion. In multivariate analysis the variables significantly associated with past abortion included less traditional attitudes about women's roles, higher gravidity, shorter periods of sexual activity, and a higher number of lifetime sexual partners. We conclude that use of abortion among Latinas is driven by role orientation and reproductive variables.

Maximizing qualitative responses about smoking in structured interviews.

This article addresses the important methodological issue of whether face-to-face or self-administered interviews elicit better qualitative data on reasons for smoking and quitting among 173 current and former smokers. The data are from a study of smoking behaviors among 601 African American and Latina women age 14 to 21 years recruited from family planning clinics in Los Angeles from 1995 to 1996. Results suggest that responses to closed questions about smoking behavior are similar in both methods but that self-administered surveys elicit more responses to open-ended questions than face-to-face interviews. The authors encourage the use of self-administered surveys in smoking research because they are cheaper to administer, yield similar data on closed-question items, and elicit richer and more provocative responses to open-ended questions.

The influence of male care givers on child health in rural Haiti.

This study examines the relationship between a woman's workload and the health of her pre-school children aged 24-59 months. The role of gender of alternate care givers when the woman is away from home is the specific focus of the research. Interviews were conducted with 106 women in rural Haiti, 44% of whom had malnourished children. Factors which significantly discriminated between normal and malnourished nutritional status were birth space between the index child and its next oldest sibling, number of children in the home, roof type (a proxy for socioeconomic status), and having a male substitute care giver. Further multivariate analysis produced a model which demonstrated that having a male care giver exacerbated the effect of birth space on nutrition status. Further research is necessary to determine characteristics of substitute care givers and their impact on nutritional status and child health in less developed countries. This is particularly important in light of the increased economic pressure on Third World rural women to work outside the home in order to meet the basic needs of their families.

Contraceptive methods: do Hispanic adolescents and their family planning care providers think about contraceptive methods the same way?

This article describes how a family planning clinic-based program to prevent repeat pregnancy among Hispanic adolescents in Los Angeles used qualitative research to understand client contraceptive behavior. Background information on Hispanic adolescent reproductive patterns and an overview of paths to motherhood among teen clients are provided to contextualize the results. Participants sorted contraceptive methods on perceived similarities and ranked them on effectiveness, safety, and use-preference. Multidimensional scaling was used to identify and compare conceptual models. Both providers and teens grouped methods by effectiveness and mode of action, but acceptability and ease of method use were also important for teens. Providers found participation a worthwhile educational experience that facilitated self-reflection about their own biases and better understanding of their clients' needs. This method could be applied in many clinical settings where education and counseling are important in treatment and where patients and providers are likely to have different conceptual models regarding therapy.

Prevalence of anal sex among heterosexuals in California and its relationship to other AIDS risk behaviors.

This paper describes the prevalence of anal sex among heterosexual adults in California and investigates the relationship of anal sex to other risk behaviors associated with AIDS and STDs. The study consisted of telephone interviews with a household probability sample of 3,545 California adults undersampling those age 44 and older. Seven percent of the sexually active respondents, 8% of males, and 6% of females reported having anal sex at least once a month during the year prior to the survey. Of these, most engage in this activity one to five times per month, and about 60% report never using condoms. Younger respondents and those who were not married were more likely to report anal intercourse. Respondents who had anal sex were more likely to report standard AIDS risks and lifestyle risks associated with STDs, and to engage in recreational use of drugs and alcohol. Both anal sex and condom use during anal intercourse were poorly predicted by these demographic and risk variables. It is concluded that a non-trivial proportion of California heterosexual adults engages in anal sex regularly, most without condoms, and those who have anal sex are more likely to have other risk behaviors associated with AIDS and STDs. These results suggest that anal sex must be addressed specifically in clinical and educational programs designed to reduce the spread of AIDS.

Lessons from a repeat pregnancy prevention program for Hispanic teenage mothers in east Los Angeles.

PIP: The conclusion of this quantitative and qualitative evaluation of 350 mothers delivering at Women's Hospital in East Los Angeles and recruited between April 1989 and December 1990 was that basic ethnographic research on teenage sexual and reproductive behavior is needed. Target groups of Hispanics, for instance, may not be homogenous and may require multiple strategies. New interventions should accommodate the effects of poverty, the influence of significant others, and the cultural meaning of relationships, pregnancy, childbearing, contraceptive use, and gender roles. Concern focused on the notion that limited program effects can be considered trivial. The point was made that bilingual mothers who had been in the US for some time and desired upward socioeconomic mobility were helped by the program. Also, the program developed referral resources in child care, school programs, employment, housing, emergency aid, and services for physical and sexual abuse. Additional funding was able to provide part-time work experiences in the clinic for a few of the teenagers, which provided more social support, solid work experience, and incentives. Through the use of qualitative data, counselors were able to prioritize teenage needs and thus supply needed food and housing before contraception. Qualitative data also helped to distinguish several different groups of Hispanics: those recent immigrants who wanted to be wives and mothers; bilingual adolescents desiring economic advancement; throw-away kids involved with drugs and gangs; and Central American teenagers who fled war-torn countries and desired a better life. There were pressing needs related to poverty and social circumstances that interfered with family planning program implementation. Recognition of the different lifestyles helped to direct services in appropriate ways. The statistical demographic profiles were presented and indicated that these teenage obstetric persons had significant social, economic, and medical risks. Many were at risk of repeat pregnancy because of living with their partner and not using contraception. Most were high school drop-outs. There was a high probability that many were illegal immigrants. Postpartum program drop-out rates were very high. Only 37 out of 244 cases and 106 controls remained after 2 years and 105 cases and 16 controls after 1 year. Residential mobility and poverty were obstacles to follow-up.^ieng

Unwanted sexual experiences among middle and high school youth.

Of the 1197 middle and high schoo students who participated anonymously in a health survey, 15% reported they had had a past unwanted sexual experience. Females were more likely than males and older students more likely than younger students to have had such experiences, which were categorized into six types: force/rape, child abuse, influence of drugs/alcohol, partner pressure, regret, and peer pressure. Male students tended to report peer pressure and regret more often than females, who tended to report forced situations and child abuse. The genders were similar, however, regarding partner pressure and the influence of drugs and alcohol. Students who reported having had an unwanted sexual experience were more likely to report current risk taking behaviors, school problems, and health problems that those who had not had such experiences. Students who had been physically forced were less likely to be currently sexually active and scored lower on a measure of current substance use than those who were not forced.

Differences in knowledge of and risk factors for AIDS between Hispanic and non-Hispanic women attending an urban family planning clinic.

Risk factors for AIDS, contraceptive use, seroprevalence of HIV, and level of knowledge before and after an AIDS education session were assessed for 657 clients attending a family planning clinic in Los Angeles, USA. History of a partner who was bisexual, an intravenous drug user, or a blood transfusion recipient were the most common risk factors. Spanish speakers reported fewer traditional risk factors than English speakers. They were also less likely to report a history of drug or alcohol use or sexually transmitted diseases, and to have had fewer sexual partners. Less than one-third of the women identified as being at risk of exposure were using condoms. None of 351 consecutive patients tested for HIV antibodies was positive. English speakers scored higher on both pre- and post-tests of knowledge about AIDS. Cultural factors may lower the personal risk of HIV exposure for Spanish-speaking women, but lack of knowledge about AIDS and partner behavior may increase risk.