"It's a touchy subject": Latino adolescent sexual risk behaviors in the school context.

Adverse sexual health outcomes remain disproportionately high for Latino adolescents. To examine sexual risk behaviors in Latino adolescents, we conducted in-depth interviews with 18 Latino parents and 13 school staff members and carried out 1 year of fieldwork in the school and community. "It's a touchy subject [sex] here" exemplified the reluctance of addressing sexual risk behaviors. Community- and systems-level strategies are recommended.

Walking out of one culture into another: health concerns of early adolescent Latinos.

Adolescence is considered a critical life transition that can lead to heightened vulnerability. Acculturation takes on increased importance during this period. The purpose of this study was to explore the relationship between acculturation and perceived health concerns of early adolescent Latinos in rural North Carolina. A qualitative descriptive design using gender-specific focus groups was conducted in the summer of 2001. Twenty-six Latino adolescents, predominantly from Mexico, participated in one of four focus groups. Acculturation was assessed using the Short Acculturation Scale (Marin & Marin, 1991). The most prevalent health concern of the girls was unsolicited physical contact and aggressive male behavior. Boys expressed concerns about stress related to financial worries and drinking alcohol. A better understanding of where Latino adolescents are located in the acculturation process can assist school nurses in developing targeted school-based prevention programs that focus on building specific skills for Latino girls and boys.

Motivations for pregnancy planning among Mexican immigrant women in North Carolina.

OBJECTIVES: To enhance understanding of 1) Mexican immigrant women's attitudes toward planning their pregnancies and the factors that influence their fertility preferences, and 2) the effect of migration on their pregnancy planning decisions. METHODS: Qualitative in-depth interviews were conducted with 11 Mexican immigrant women living in North Carolina. Participants were recruited by means of snowball sampling. Interviews were conducted in Spanish in the women's homes. Interviewing and analysis were conducted iteratively to allow emerging themes and interpretations to be developed and validated in subsequent interviews. RESULTS: The women were strongly motivated to plan their pregnancies. Their primary considerations in pregnancy planning were their ability to give their children a good life and their ability to enjoy their families. Individual personal aspirations did not emerge as an important consideration. Migration intensified the women's felt need to plan their pregnancies. CONCLUSIONS: The Mexican immigrant women in this study had a strong familistic orientation. Far from diminishing their interest in planning their pregnancies, however, the high value they placed on family was their primary motivation for pregnancy planning. Migration to the U.S. intensified their felt need to plan their pregnancies. Understanding of the women's motivations for family planning may help health care providers better address the family planning needs of Mexican immigrant women.

Community-based participatory research with Latino community members: horizonte Latino.

As the demographic makeup of the United States undergoes rapid transformation, the importance of studying ethnic and cultural variations between and within population subgroups becomes increasingly clear. Researchers must challenge themselves to move beyond simply matching their methodology to the research question at hand and seek out methods that are compatible with the culture, language, traditions, and particular life circumstances of the cultural group under study. Community-based participatory research is collaborative and includes community members as participants in the research process, which ensures the cultural and community specificity of the research. This article demonstrates how experiential learning of community members as research participants provided culturally grounded insights used in grant writing. The experiences and involvement of the community researchers shaped the research questions and provided the major conceptual basis in response to a National Institutes of Health Request for Applications.

Migration and relationship power among Mexican women.

Our study drew on original data collected in Durham, NC, and four sending communities in Mexico to examine differences in women's relationship power that are associated with migration and residence in the United States. We analyzed the personal, relationship, and social resources that condition the association between migration and women's power and the usefulness of the Relationship Control Scale (RCS) for capturing these effects. We found support for perspectives that emphasize that migration may simultaneously mitigate and reinforce gender inequities. Relative to their nonmigrant peers, Mexican women in the United States average higher emotional consonance with their partners, but lower relationship control and sexual negotiation power. Methodologically, we found that the RCS is internally valid and useful for measuring the impact of resources on women's power. However, the scale appears to combine diverse dimensions of relationship power that were differentially related to migration in our study.

Use of commercial sex workers among Hispanic migrants in North Carolina: implications for the spread of HIV.

CONTEXT: Rates of HIV and AIDS have risen among U.S. Hispanics and in migrant-sending regions of Mexico and Central America, pointing to a link between migration and HIV. However, little is known about male migrants' sexual risk behaviors, such as the use of commercial sex workers. METHODS: The prevalence and frequency of commercial sex worker use was examined among 442 randomly selected Hispanic migrants in Durham, North Carolina. Logistic and Poisson regression techniques were used to model predictors of commercial sex worker use, and descriptive data on condom use with commercial sex workers were examined. RESULTS: Twenty-eight percent of respondents reported using the services of a commercial sex worker during the previous year; rates reached 46% among single men and 40% among married men living apart from their wives. Men with spouses in Durham were less likely than other men to use commercial sex workers (odds ratio, 0.1). Among men who used commercial sex workers, the frequency of visits declined with greater education (incidence rate ratio, 0.9) and increased with hourly wage (1.1). Frequency and use declined with years of residence, although the results were of borderline significance. Reported rates of condom use with commercial sex workers were high, but were likely to fall if familiarity with a commercial sex worker increased. CONCLUSIONS: Commercial sex workers represent an important potential source of HIV infection. Educational and behavioral interventions that take into account social context and target the most vulnerable migrants are needed to help migrants and their partners avoid HIV infection.

"If they don't ask about condoms, I just tell them": a descriptive case study of Latino lay health advisers' helping activities.

Health care practitioners have increasingly turned to lay health advisers (LHAs) to deliver health promotion and disease prevention supportive activities to underserved populations. Yet, published evaluations of the LHA programs or the manner in which LHAs deliver information are rare. An important aspect of program evaluation includes understanding the role of the LHA in the community as described by the LHAs in the field. The purpose of this article is to report the results of a component of a larger evaluation of an LHA program for preventing HIV/AIDS among recently immigrated Mexicans in North Carolina. Specifically, the authors use a descriptive case study design to report on the perceptions of the LHAs related to program objectives. The findings suggest that the LHAs are meeting the program objectives and are confident in their role as LHAs.

AIDS knowledge and measurement considerations with unacculturated Latinos.

Likert-type scales are frequently used in research with different ethnic groups. Differences in cultural response styles and understanding of the scale have long been noted but rarely explored in research. This article presents the authors' experiences in using a Likert-type questionnaire to measure AIDS knowledge among recently arrived Mexican immigrants in the southeastern United States. The questionnaire findings were compared to a qualitative assessment using vignettes to ascertain knowledge of AIDS casual transmission. It was found that a lack of association existed between the respondents' answers to the quantitative AIDS Likert-type scale and the qualitative vignettes. In-depth interviews to understand the problems respondents were having with the scaling (linguistics, format, and wording of the AIDS questionnaire) supported the findings of a lack of association between the two methods of knowledge assessment. The findings suggest that the Likert-type format is confusing for, and does not accurately reflect knowledge in, recently arrived Mexican immigrants.