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中跨性别、异性恋和 LGBTQIA + 青少年在边境地区的性与生殖保健障碍:提供者和青少年的观点。

Barriers to sexual and reproductive care among cisgender, heterosexual and LGBTQIA + adolescents in the border region: provider and adolescent perspectives.

机构信息

College of Health and Human Sciences, Purdue University, Matthews Hall, 214A, West Lafayette, IN, 47907, USA.

San Ysidro Health, 333 H Street, Suite 2080, Chula Vista, CA, 91910, USA.

出版信息

Reprod Health. 2022 Apr 12;19(1):93. doi: 10.1186/s12978-022-01394-x.


DOI:10.1186/s12978-022-01394-x
PMID:
Abstract

INTRODUCTION: The United States (U.S.) has higher rates of sexually transmitted infections (STIs) and adolescent pregnancy than most other industrialized countries. Furthermore, health disparities persist among racial and ethnic minority adolescents (e.g., African American and Latinx) and in counties located along the U.S.-Mexico border region-they demonstrate the highest rates of STIs and unintended pregnancy among adolescents. METHODS: Qualitative data were collected as part of formative research for the development of a mobile app that provides gender-inclusive sexual education to adolescents living in the U.S.-Mexico border region. From August 2019 to March 2020, the study team conducted 11 in-depth interviews with healthcare providers and three focus groups with cisgender, heterosexual, and SGM adolescents ages 15-18 (n = 20). RESULTS: Providers and adolescents reported similar barriers to accessing SRH in this region such as transportation, lack of insurance and cost of services or accessing services without their parent's knowledge. However, providers shared that some adolescents in this region face extreme poverty, family separation (i.e., parent has been deported), have a mixed family legal status or are binational and have to travel every day from Mexico to the U.S. for school. These challenges further limit their ability to access SRH. CONCLUSIONS: Adolescents in the U.S.-Mexico border region face unique economic and social challenges that further limit their access to SRH care, making them uniquely vulnerable to STIs and unintended pregnancy. The prototype of the app was developed based on the needs expressed by providers and adolescents, including providing comprehensive Sex Ed and mapping of free comprehensive and confidencial SRH services available in the region and is being pilot tested. Our findings provide further evidence for the need for interventions and service delivery, programs tailored for residents in the border region.

摘要

简介:美国(U.S.)的性传播感染(STIs)和青少年怀孕率高于大多数其他工业化国家。此外,在少数族裔青少年(如非裔美国人和拉丁裔)和位于美国-墨西哥边境地区的县中,仍然存在健康差距——他们表现出最高的 STIs 和青少年意外怀孕率。

方法:定性数据是作为开发为居住在美国-墨西哥边境地区的青少年提供性别包容的性教育的移动应用程序的开发的形成性研究的一部分收集的。研究团队于 2019 年 8 月至 2020 年 3 月期间,与医疗保健提供者进行了 11 次深入访谈,并与 cisgender、异性恋和 SGM 青少年(15-18 岁,n = 20)进行了三次焦点小组讨论。

结果:提供者和青少年报告说,在该地区获取 SRH 存在类似的障碍,例如交通、缺乏保险和服务费用或在父母不知情的情况下获取服务。然而,提供者表示,该地区的一些青少年面临极端贫困、家庭分离(即父母被驱逐出境)、家庭法律地位混杂或具有双重国籍并每天从墨西哥前往美国上学等问题。这些挑战进一步限制了他们获得 SRH 的能力。

结论:美国-墨西哥边境地区的青少年面临独特的经济和社会挑战,进一步限制了他们获得 SRH 护理的机会,使他们特别容易受到 STIs 和意外怀孕的影响。该应用程序的原型是根据提供者和青少年表达的需求开发的,包括提供全面的性教育和绘制该地区免费的全面和保密的 SRH 服务地图,并正在进行试点测试。我们的研究结果进一步证明了需要为边境地区的居民提供干预和服务交付、量身定制的计划。

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[4]
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[5]
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[6]
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[7]
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[8]
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本文引用的文献

[1]
"At Least I Didn't Get Raped": A Qualitative Exploration of IPV and Reproductive Coercion among Adolescent Girls Seeking Family Planning in Mexico.

J Interpers Violence. 2022-4

[2]
Health-Related Quality of Life and Health Literacy among Mexican American and Black American Youth in a Southern Border State.

Soc Work Public Health. 2020-3-2

[3]
Health Profile and Health Care Access of Mexican Migration Flows Traversing the Northern Border of Mexico.

Med Care. 2020-5

[4]
Development of a Mobile Phone App to Promote Safe Sex Practice Among Youth in Stockholm, Sweden: Qualitative Study.

JMIR Form Res. 2020-1-28

[5]
The HIV Pre-exposure Prophylaxis (PrEP) Cascade at NYC Sexual Health Clinics: Navigation Is the Key to Uptake.

J Acquir Immune Defic Syndr. 2020-4-1

[6]
Access to public transportation and health facilities offering long-acting reversible contraceptives among residents of formal and informal settlements in two cities in Kenya.

Reprod Health. 2019-11-8

[7]
Applying a community-based participatory research framework to patient and family engagement in the development of patient-centered outcomes research and practice.

Transl Behav Med. 2018-9-8

[8]
Childhood Experiences of Sexual Violence, Pregnancy, and Marriage Associated With Child Sex Trafficking Among Female Sex Workers in Two US-Mexico Border Cities.

Am J Public Health. 2018-6-21

[9]
The growing epidemic of sexually transmitted infections in adolescents: a neglected population.

Curr Opin Pediatr. 2018-2

[10]
Community-based participatory research and integrated knowledge translation: advancing the co-creation of knowledge.

Implement Sci. 2017-12-19

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