Hill Ashley V, Balascio Phoebe, Moore Mikaela, Wilson Tyia, Fields Alana, Miller Elizabeth
Division of Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, Illinois; Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania.
Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania.
J Adolesc Health. 2025 Feb;76(2):316-322. doi: 10.1016/j.jadohealth.2024.10.009. Epub 2024 Nov 5.
Structural racism and racial discrimination may increase adverse sexual health outcomes in Black adolescent girls. However, the influence of racism on sexual health has not been well-described in qualitative studies. The purpose of this study was to explore definitions of structural racism and determine how experiences of racial discrimination impact sexual health and decision-making in a sample of adolescent Black girls.
Black girls aged 13-19 years were recruited from an ongoing longitudinal study. Virtual focus groups and individual interviews were facilitated, inquiring about understandings of structural racism, experiences with discrimination, and factors that influence sexual health decision-making and healthcare-seeking. Transcripts were professionally transcribed and coded by two independent, blinded team members. Thematic content analysis was used to identify emergent themes.
Four themes emerged as follows: (1) slavery and medical racism in the United States impact the sexual and reproductive health (SRH) choices of Black girls; (2) stereotypes and oversexualization of Black girls are considered a barrier to SRH education; (3) adults serve as both barriers and facilitators to SRH and resource utilization; and (4) Black girls often seek information from friends or social media outlets to make SRH decisions.
Reproductive health education for Black girls should integrate historical influences of systemic oppression. Practitioners should include reproductive justice to build trust in clinical and community spaces. Engaging caregivers in health education may reduce barriers for youth to engage in care.
结构性种族主义和种族歧视可能会增加黑人少女不良的性健康后果。然而，种族主义对性健康的影响在定性研究中尚未得到充分描述。本研究的目的是探讨结构性种族主义的定义，并确定种族歧视经历如何影响青少年黑人女孩样本中的性健康和决策。
从一项正在进行的纵向研究中招募13 - 19岁的黑人女孩。开展了虚拟焦点小组和个人访谈，询问对结构性种族主义的理解、歧视经历以及影响性健康决策和寻求医疗保健的因素。由两名独立、不知情的团队成员对访谈记录进行专业转录和编码。采用主题内容分析法来识别新出现的主题。
出现了四个主题，如下所示：(1)美国的奴隶制和医学种族主义影响黑人女孩的性健康和生殖健康（SRH）选择；(2)对黑人女孩的刻板印象和过度性化被认为是性健康和生殖健康教育的障碍；(3)成年人既是性健康和生殖健康及资源利用的障碍，也是促进因素；(4)黑人女孩在做出性健康和生殖健康决策时，常常向朋友或社交媒体平台寻求信息。
针对黑人女孩的生殖健康教育应纳入系统性压迫的历史影响。从业者应纳入生殖正义，以在临床和社区空间建立信任。让照顾者参与健康教育可能会减少青少年接受护理的障碍。
