The Socioecology of Sexual and Reproductive Health Care Use Among Young Urban Minority Males

J Adolesc Health. 2017 Apr;60(4):402-410. doi: 10.1016/j.jadohealth.2016.11.014. Epub 2017 Jan 5.

Abstract

Purpose: To explore perceptions of facilitators/barriers to sexual and reproductive health (SRH) care use among an urban sample of African-American and Hispanic young men aged 15-24 years, including sexual minorities.

Methods: Focus groups were conducted between April 2013 and May 2014 in one mid-Atlantic U.S. city. Young men aged 15-24 years were recruited from eight community settings to participate in 12 groups. Moderator guide explored facilitators/barriers to SRH care use. A brief pregroup self-administered survey assessed participants' sociodemographics and SRH information sources. Content analysis was conducted, and three investigators independently verified the themes that emerged.

Results: Participants included 70 males: 70% were aged 15-19 years, 66% African-American, 34% Hispanic, 83% heterosexual, and 16% gay/bisexual. Results indicated young men's perceptions of facilitators/barriers to their SRH care use come from multiple levels of their socioecology, including cultural, structural, social, and personal contexts, and dynamic inter-relationships existed across contexts. A health care culture focused on women's health and traditional masculinity scripts provided an overall background. Structural level concerns included cost, long visits, and confidentiality; social level concerns included stigma of being seen by community members and needs regarding health care provider interactions; and personal level concerns included self-risk assessments on decisions to seek care and fears/anxieties about sexually transmitted infection/HIV testing. Young men also discussed SRH care help-seeking sometimes involved family and/or other social network members and needs related to patient-provider interactions about SRH care.

Conclusions: Study findings provide a foundation for better understanding young men's SRH care use and considering ways to engage them in care.

Keywords: Access to care; Barriers to care; Male adolescents; Sexual and reproductive health care use; Young adult men.

MeSH terms

  • Adolescent
  • Attitude to Health / ethnology*
  • Black or African American / psychology
  • Black or African American / statistics & numerical data
  • Communication
  • Decision Making
  • Focus Groups
  • Health Expenditures
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Minority Health* / economics
  • Patient Acceptance of Health Care / ethnology
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Professional-Patient Relations
  • Qualitative Research
  • Reproductive Health Services / economics
  • Reproductive Health Services / statistics & numerical data*
  • Risk Assessment
  • Self-Assessment
  • Sexual Health / economics
  • Sexual Health / ethnology*
  • Sexual Health / statistics & numerical data
  • Sexual and Gender Minorities / psychology
  • Sexual and Gender Minorities / statistics & numerical data
  • Urban Health / economics
  • Urban Health / ethnology*
  • Urban Health / statistics & numerical data
  • Young Adult