Futuros Saludables [Healthy Futures]: Knowledge, Beliefs and Attitudes about Contraception among Rural Latino Youth in Kansas

Abstract

Abstract Background: Pregnancy rates for Latino teens in rural areas are higher than White non-Hispanics peers. Although Latino teens are the fastest growing teen minority in the country, efforts to attend to their reproductive health needs have lagged behind. The aim of this manuscript was to explore knowledge, beliefs and attitudes about contraception among teens in the rural Latino community to inform culturally appropriate strategies for teen pregnancy prevention. Design: Adolescents aged 15-24 years from a Latino rural Kansas community completed a survey and participated in a focus groups. The survey assessed demographics, acculturation, reproductive health care access, pregnancy intentions, contraceptive methods use and knowledge. Focus groups discussed the intertwined complex relationship among attitudes, subjective norms, perceived sexual behaviors, teen pregnancy, and contraception. Results: Participants (107) completed the survey and participated in focus groups. Mean age of participants was 18.0 (SD=2.8), 43.0% were female and most were Christian (85.7%) and self-identified as Hispanic/ Latino (86%). According to the Short Acculturation Scale for Hispanics (SASH), acculturation levels were high. Results from the focus groups, supported by data from surveys described multiple layers of difficulties that that placed these young participants at a higher risk of teen pregnancy: Geographical/rural access, Cultural barriers, Religious influences, lack of sexual education and personal attitudes towards pregnancy and contraception use. Overall Rural Kansas seems to be a close knit community that reports heavy familial expectations of abstinence “staying virgin till matrimony”. Furthermore, this community follows religious beliefs on contraception mechanism of action, attributing abortive action and immorality to it. Cultural and religious influences characterize family planning behaviors in this Latino youth rural community (sexual taboo, virginity and Marianismo, Familismo, family dishonor) and obstruct discussions, education and access to sexual health and contraception knowledge and services. Conclusions: Despite engaging in sexual behaviors counter to familial and religious expectations, the combination of significant myths and misconceptions, and lack of sexual education on contraception added to limitations in access to family planning services likely contribute to the high rates of unplanned pregnancy among Latino adolescents and young adults living in rural Kansas. Our findings of parental influences and expectations coupled with strong concepts misleading the knowledge on mechanism of action and consequences of birth control use, strongly underscore the need for a culturally-relevant community-based pregnancy prevention intervention that targets specific demystification of contraception in a frame of specific parental expectations and education.