IMPLICATIONS OF MEASURES OF HISPANIC ETHNICITY FOR STD PREVENTION AND TRANSMISSION

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IMPLICATIONS OF MEASURES OF HISPANIC ETHNICITY
FOR STD PREVENTION AND TRANSMISSION

• Mary B. Adam, MD
• and the
• Informatics and Decision Making Laboratory,
  University of Arizona College of Medicine

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How do you measure ethnicity?

• Skin color/race
• Country of birth/continent of origin
• Parents/Grandparents national origin
• Surname/name analysis
• Self perception
• Shared language

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Hispanic Origin Form US Census 2000NO Box if
Not Spanish/Hispanic/Latino

• No, Not Spanish/Hispanic/Latino
• Yes, Mexican, Mexican American, Chicano
• Yes, Puerto Rican
• Yes, Cuban
• Yes, Other Spanish/ Hispanic/Latino______
• _____________, Salvadoran, Dominican etc

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Heterogeneity in Hispanic Populations

• Recent immigrant-legal/illegal
• Family could have lived in this region for
  hundreds of years and under several different
  flags
• English speakers
• Spanish speakers
• Retain strong ties with country of origin or may
  had adopted attitudes values and beliefs of the
  dominant culture.

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NIH Project Aims

• (1) to evaluate measures of Hispanic Ethnicity
  (Phase I)
• (2) to measure differences in sexual
  beliefs/values/attitudes in Hispanic versus Anglo
  teens and in high risk versus low risk teens
  (Phase I).
• (3) To measure differences in reasons for risky
  sexual decisions in Hispanic versus Anglo teens
  and in high risk and low risk teens (Phase I)
• (4) to use the data from (1) and (2) in a new
  curriculum for reducing and avoiding sexual risk
  in teens (Phase II).

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Measures of Hispanic Ethnicity

• Self-reported Ethnicity
• Subjects birth country
• Parents and Grandparent's birth country
• Language Use Scales
• Religion

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Description of sample

• 255 Adolescents age 14-19
• Gender
• 45 male 55 female
• Ethnicity
• 45 Mexican American/Hispanic
• 40 Anglo
• 14 Mixed ethnicity
• 1 Black
• lt1 Central/South American
• lt1Native American
• lt1 Asian

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Description of Sample

• Anglo
• 98 speak English
• 99 Born in the United States
• 27 Protestant
• 16 Catholic
• Hispanic
• 41 speak English, 20 speak Spanish
• 78 born in the United States
• 18 Protestant
• 70 Catholic

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Factor Analysis

• Language Use 54 variance
• Country born 8 variance
• Spanish media 6 variance
• Religion importance 6 variance
• Self born 4 variance
• Catholic/nonCatholic 3 variance

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Hierarchical Cluster Analysis

• Generation born
• English language use
• Spanish language use

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Rates of Sexual Activity by Gender and Ethnicity

• 49 of males reported sexual activity
• 49 of females reported sexual activity
• 48 of Anglos reported sexual activity
• 44 of Hispanics reported sexual activity

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Rates of Sexual Activity by Country of Birth

• 38 of foreign born Hispanics reported being
  sexually active
• 48 of US born Hispanics reported being sexually
  active
• 48 of US born Anglos reported being sexually
  active.

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Rates of Sexual Activity by Language Use How
often do you speak Spanish in general?

• 34 of Hispanics who almost always spoke
  Spanish were active
• 45 of Hispanics who often or sometimes spoke
  Spanish were active
• 55 of the Hispanics who reported almost never
  were sexually active

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Rates of Sexual Activity by Religious Affiliation

• 40 of Catholics reported being sexually active
• 54 of non Catholics reported being sexually
  active

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Individuals within ethnic groups are not
homogenous in their beliefs, values, experiences,
or behavior.
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Culture vs Context

• Family structure
• Availability of family members
• Social economic status
• Educational attainment
• Discrimination
• Access to health care

• Language barriers
• Religiosity
• Perceptions about illness, treatment,
  physician-patient roles
• Value of maternal role
• Acculturation