Adolescent Latina Sexual Health: A Longitudinal Evaluation of the Impact of Religiosity and Acculturation

Purpose: This study assesses the impact of adolescent religiosity and acculturation on sexual health among Latinas in young adulthood. Latinas experience the confluence of many risks identified in the literature for STIs, and data indicates they have higher rates of STIs than their non-Hispanic peers. High-religiosity and low-acculturation have been identified as both risk and protective factors for sexual health, and this study utilizes new measurement techniques in an attempt to improve the understanding of the impact of these factors on sexual health. Method: Using data from the National Longitudinal Study of Adolescent Health, a nationally representative sample of self-identified Hispanic females (N=887) was analyzed using SEM. Religiosity was measured by five items comprising two latent structures - intrinsic religiosity and extrinsic religiosity. Acculturation was measured by a single latent variable comprised of five items. Three dependent variables were assessed: Unprotected sex, risky sexual behavior, and STI diagnosis. Unprotected sex was a count variable of the number of times the respondent had unprotected oral, anal, or vaginal sex during their first sexual encounter with reported partners. Risky sexual behavior was measured by summing 13 dichotomized items reflecting risky sexual practices. STI diagnosis was measured from the respondent's report and from biomarker data for five of the most common STIs: Chlamydia, gonorrhea, HPV, HSV, and HIV. Results: Results suggest that higher intrinsic religiosity and lower acculturation are protective against all three outcomes while extrinsic religiosity increased risk. For unprotected sex, a one standard deviation increase in intrinsic religiosity and acculturation resulted in a decrease (.98 and.78 units respectively, p<.001) of unprotected sex acts but the same increase in extrinsic religiosity resulted in a .91 unit increase (p<.01). Extrinsic religiosity also increased the risk for STIs; a one standard deviation increase in extrinsic religiosity created a .38 unit rise in STI score (p<.01). Intrinsic religiosity and acculturation had the opposite effect, lowering the STI score by .39 and .44 respectively (p<.01 for both). For risky sexual behaviors, the drop in Z-score from a one-unit increase in acculturation and intrinsic religiosity was 1.97 (p=.058) and 2.45 (p<.05) respectively. For each point increase in extrinsic religiosity, the probit index for risky sexual behavior rose 2.40 (p<.01). Implications: The protective benefits religiosity appears to come from the type of religiosity, with intrinsic religiosity offering protection and extrinsic religiosity increasing risk. The risk from higher levels of extrinsic religiosity may be attributable to greater access to potential partners, restricted access to sexual health information, and parental presumptions of supervision at religious activities where little or no supervision is provided. The finding that lower acculturation was protective confirms the bulk of the literature, and because religious identity and culture are interwoven for many Latinas, the modeling of these factors together provides some evidence for improving social work practice with Latinas. Specifically, focusing on skill enhancement related to sexual decision making (e.g. refusal and avoidance) and improving community partnerships (e.g. screening/education with ecclesial institutions) may help social workers improve the sexual health of Latinas.