Lindberg Claire, Lewis-Spruill Carolyn, Crownover Rodney
School of Nursing, The College of New Jersey, Ewing, New Jersey, USA.
Issues Compr Pediatr Nurs. 2006 Apr-Jun;29(2):73-88. doi: 10.1080/01460860600677577.
Risky sexual behaviors among adolescent males put them at risk for sexually transmitted diseases, HIV/AIDS, and unplanned fatherhood, yet few facilities in the United States provide focused sexual and reproductive health services to these young men. A general acknowledgement exists that the development of such services is needed, yet there is little research to guide providers in making existing services more attractive to young males and in developing new sexual health services for this population.
This research aimed to explore attitudes and perceptions of urban black male adolescents regarding the availability of and access to reproductive healthcare.
Eighteen black male adolescents participated in three focus group discussions held in a central New Jersey city. Transcripts of the discussions were analyzed using the constant comparative method. Resulting categories were grouped into themes, which reflected the adolescents' perceptions and experiences. Member checks were used to verify findings.
The adolescents felt that obtaining sexual health services was a stressful experience fraught with both internal and external barriers. Internal barriers included a fear of stigma and a loss of social status, shame, and embarrassment. External barriers included disrespectful providers, a lack of privacy/confidentiality, and challenges in accessing and negotiating the healthcare system. The young males described an idealized clinic environment as informal, welcoming, and respectful.
Providers should focus on improving the quality of care in existing clinics, particularly in the areas of access, privacy, and confidentiality, and on developing adolescent-friendly clinics focusing on male services. Adolescents should be encouraged to visit clinics prior to an acute need for services. There also is a need for providers who are comfortable with and able to communicate with male adolescents.
青少年男性的危险性行为使他们面临感染性传播疾病、艾滋病毒/艾滋病以及意外成为父亲的风险，然而美国很少有机构为这些年轻男性提供针对性的性与生殖健康服务。人们普遍认识到需要发展此类服务，但几乎没有研究来指导提供者如何使现有服务对年轻男性更具吸引力，以及如何为这一人群开发新的性健康服务。
本研究旨在探索城市黑人男性青少年对生殖健康护理的可及性和获取情况的态度与看法。
18名黑人男性青少年参与了在新泽西州中部一个城市举行的三场焦点小组讨论。使用持续比较法对讨论记录进行分析。得出的类别被归纳为主题，这些主题反映了青少年的看法和经历。通过成员核对来验证研究结果。
青少年认为获得性健康服务是一次充满压力的经历，存在诸多内部和外部障碍。内部障碍包括害怕被污名化、社会地位丧失、羞耻和尴尬。外部障碍包括提供者不尊重、缺乏隐私/保密性以及在进入和应对医疗系统方面存在挑战。这些年轻男性将理想的诊所环境描述为非正式、热情且尊重人的。
提供者应专注于提高现有诊所的护理质量，特别是在可及性、隐私和保密性方面，并开发以男性服务为重点的青少年友好型诊所。应鼓励青少年在急需服务之前就去诊所就诊。还需要有能与男性青少年融洽相处并进行沟通的提供者。
