Acculturation and sexual behaviors among Latina adolescents who are transitioning to young adulthood

PURPOSE:

Latinas in the United States are at a disproportionate risk for STDs and sexual risk behaviors (CDC, 2002, 2006). Several studies highlight acculturation factors associated with sexual behaviors; (Guliamo-Ramos et al, 2005; McDonald et al, 2009) however, few studies use a longitudinal design to examine the role of acculturation in predicting STDs and sexual risk behaviors among a nationally representative sample. Furthermore, if acculturation is associated with higher risks of STDs and sexual risk behaviors, it is necessary to examine whether these acculturation predicts STD testing behaviors. Therefore, this study examined the longitudinal association between Latinas' acculturation (1995) and four sexual outcomes including self-report STD diagnosis, 4 or more life time sex partners, regret of sexual initiation after alcohol use, and STD testing (2001), controlling for covariates.

METHODS:

Data were obtained from the National Longitudinal Study of Adolescent Health (Add Health) wave 1 (1995, ages 11-21) and wave 3 (2001, ages 18-27). A nationally representative sample of Latinas (N=1,026) was analyzed. Acculturation variables were examined by categorizing Latinas into four groups; Foreign born & Non-English speaking at home, the least acculturated group (Group 1); US born & Non-English speaking at home (Group 2); Foreign born & English speaking at home (Group 3); and US born & English speaking at home, the most acculturated group (Group 4). Chi-square tests and multivariate logistic regression analyses were conducted with consideration to the complex survey design.

RESULTS:

Approximately, 10% of young Latinas had a history of STD and regretted sexual initiation after alcohol use. Roughly 40% had 4 or more lifetime sex partners and 30% received STD testing. Overall, Groups 3 and 4 were found to be engaged in higher proportions of risk behaviors including STDs, 4 or more lifetime sex partners, sexual initiation after alcohol use, and STD testing. Specifically, Group 3 was more likely to have had a STD, have 4 or more life time sex partners, and regretted sexual initiation after alcohol use (ORs=6.62, 8.51, and 10.67, respectively) compared to Group 1. Compared to Group 1, Group 4 members were more likely to have had a STD (OR=5.71), have 4 or more life time sex partners (OR=4.83). Group 4 were also 4 times more likely to get STD testing compared to Group1. Although Group 3 had highest odds of having a history of STDs and the highest odds of being engaged in various risky sexual behaviors, their likelihood of getting STD testing was not significantly different from Group 1.

CONCLUSIONS:

This study makes a significant contribution to the growing literature on factors affecting sexual and reproductive health among young Latinas. This study indicated that Group 3 had the highest risk of self reported STDs, 4 or more life time sex partners, sexual initiation after alcohol use, and STD testing. Programs focusing on preventing risky sexual outcomes and promoting STD testing behaviors for young Latinas at highest risk need to be developed and evaluated. Taking these steps may improve sexual and reproductive health and reduce health disparities among young Latinas.