Sexual Health of Latino Youth: Making Sexuality Education Culturally Appropriate

1. Sexual Health of Latino Youth: Making Sexuality Education Culturally Appropriate Raffy R. Luquis, Ph.D., MCHES, FAAHE Associate Professor of Health Education School Of Behavioral Sciences and Education

2. Objectives At the end of this presentation, participants will be able to… • The participants will be able to identify at least three beliefs and values that are important in Latino culture. • The participants will be able to identify and compare at least three myths and stereotypes of sexual expression among Latinos. • The participants will be able to identify at least three strategies and resources for making sexuality education more culturally appropriate for Latino youth and their families.

3. Hispanics/Latinos in U.S. • The largest and fastest-growing ethnic group in the U.S. • 2010 – 50.5 million (16%) • 2050 – 132.8 million (30%) • Accounted for most of the nation's growth—56% from 2000 to 2010.

4. Hispanics/Latinos Characteristics • Median age: 25 yrs. • Language other than English: 69% • Family households: 83% • Hispanic Homeownership: 46% • Median annual personal income: $22,405 • Median household income: $41,041 • U.S. Citizenship: 85% Pew Hispanic Center 2010

5. Religion • More than two-third (68%) of Latinos indentify themselves as Roman Catholics; representing 1/3 of all Catholics in the U.S. • The majority (66%) of them prefer to attend Hispanic congregations. • 15% are born-again or Evangelical Protestant. • Many of Latinos joining Evangelical churches are Catholic converts.

6. Straddling Two Worlds • 20 million people have come to the U.S. Latin America since 1965. • Largest immigration modern US history. • About half (52%) ages 16-25 identify themselves first by their families country of origin. • 20% more first describe themselves as “Hispanic” or “Latino.”

7. Issues of Acculturation • There are 4 generations of Latinos in the US: • 1st generation: arrived at 12 yrs of age or older • 1.5 generation: arrived very young (younger than 12) • 2nd generation: born in the US with foreign born parents • 3rd generation: born in US with US born parents • Each generation has varying degrees of acculturation levels.

8. Latino Cultural Values

9. Gender Roles Males Females Machismo Patriarch “Don Juan” Expected to desire sex and explore their sexuality. “Piropos” – statements with sexual connotations expressed toward women Marianismo Caregivers “Virgin-Whore” Expected to be proper on their sexual behaviors. “Coqueteria” – female behaviors that reinforce sexual attraction.

10. Sexual Orientation • Those with traditional views are less accepting of homosexuality. • Same gender sexual activity is highly stigmatized, especially among women. • Males will engage in sex with other males • Satisfied their sexual needs. • Under the influence of alcohol. • A study conducted by Yon-Leau & Muñoz-Laboy (2010) showed that adolescents struggle over meanings and labels of sexual orientation.

11. Familialism • Family is the most important institution in life, cultural and social existence. • Strong feeling of loyalty, reciprocity, and solidarity among its members. • Family members: • “Parientes” - blood relatives • “Parentesco”- bond within nuclear, and extended and non-relative family. • “Compadrazgo”- godparent, important role. • Confianza - trust, respect, dignity & intimacy. • The elders are highly respected.

12. Marriage • Highly valued among Latinos. • No difference between legal marriage and cohabitation. • Liberal views of marriage are associated to increase premarital sexual activity among adolescents. • Ideal marriage age is 23-27.

13. Relationships • Simpatía • The need for behaviors that promotes smooth and pleasant social relationships. • Pronatalism • Encouragement and support of childbearing • Closeness • Preference for shorter distance and feeling comfortable with closeness in personal space

14. Sexuality and Latinos

15. Teen Birth Rates by Race/Ethnicity

16. Latinos and Sexual Behaviors YRBSS, 2009

17. Latinos and Sexual Behaviors YRBSS, 2009

18. Sexual Initiation by Generation Status

19. Pregnancy and Latinos • 1 in 2 Latina teens will become pregnant by age 20. • 1 in 4 becomes a mother before age 20. • 69% percent of Latina teen moms drop out of high school. • Nearly 80% of teen moms never marry the father.

20. Pregnancy Intentions • Reasons for getting pregnant: • Retaining partner or to please partner • Move out of the house • Desire to give baby new opportunities • Grow up or mature • Start a family

21. Contraceptive Use by Generation Status

22. Contraceptive Use by Language

23. Contraception Attitudes • Lack of contraception use due to… • Latino college students have more negative attitudes about condoms than Whites and Blacks (Espinose-Hernandez, Lefkowtiz, 2009). • Reasons Latinas do not use birth control: weight gain, bleeding, acne, and depression (Gilliam, Warden, Goldstein, Tapia, 2004), fear parents find out. • Belief condoms break, lack of feeling.

24. Contraception and Acculturation • Latino teens raised in English only households were more likely to use contraception during their first intercourse (Suellentrop & Sugrue, 2008). • Spanish speaking Latinas experienced feeling of emotional stress, anxiety, and nervousness due to contraceptive hormonal methods (Guendelman, 2000). • Foreign born and less acculturated, have misconceptions about the effectiveness and safety of hormonal contraception (Gilliam, 2004).

25. Negotiating Contraception Use • Partner’s machismo main reason Latinas do not contraception and they on them to purchase contraception, such as the pill (Rivera, Méndez, Gueye, & Bachmann, 2007). • Foreign born Latinas…contraception was the woman’s responsibility (Sangi-Haghpeykar, Ali, Posner, & Poindexter, 2006). • Almost 40% of women with partners 4-6 years older used no contraception. (CDC, 2004) • Contraception use changes as a relationship develops. As it get serious, condoms are dropped and the pill or nothing is used.

26. Parents and Sexual Behavior • Maternal communication is associated with reduced sexual risk taking behaviors (Trejos-Castillo & Vazsonyi, 2009). • High levels of connectedness between parents and family are associated with delayed sexual initiation (Kirby, Lepore & Ryan, 2005).

27. Parents and Sex Education • Almost 50% Latino teens say that parents most influence their decisions about sex. • Latina adolescents want to have open communication about sexuality with their mothers (Gilliam, 2007a). • 79% teens reported a conversation with parents about sex, 73% about relationships, 49% about contraception.

28. Parents Unwilling Educators • Some parents feel anxious, thinking that they will provide too much information. • Others are embarrassed by not having answers to questions that children make. • 3 in 4 parents said that when it comes to sex, they often don’t know what to say, how to say it, or when to start.

29. Sex Education Left to Others • Sex education is often the responsibility of the mother, but… • Latino parents may rely on the school, and in some cases the media, to educate their children about sexuality. • Mothers trust their social environment and culture to relay traditional views of behavior and morality to their daughters, but do not talk about it (Gilliam, 2007a; Raffaelli, 2004). • Sexuality education may come from extended family members (aunts, uncles, grandparents).

30. Parents and Gender Education • Latino young adults learn traditional gender roles from their parents (Raffaelli, 2004). • Latino parents play a crucial role in the sexualization and sexual decisions of their children (Raffaelli & Ontai, 2001; Upchurch, Aneshensel, Mudgal, & Sucoff McNeely, 2001).

31. Gender Based Sex Education • Three-quarter of teens believe that parents send different messages to their sons and daughters Girls are encouraged to remain abstinent. • Boys are encouraged to have sex, particularly by dad. • Mothers are more accepting of boys having sex. • Fathers are less accepting of their daughters having sex.

32. Protective Factors • Religion • Religion…[is a] protective factor for early sexual initiation and pregnancy prevention (Kirby, Lepore, & Ryan, 2005; Rasberry & Goodson, 2009). • Latinas who attend church … hold more traditional attitudes, have fewer sexual partners, and are less likely to ever had sex (Edwards, Fehring, Jarrett, & Haglund, 2008). • School • School connectedness and high academic aspirations were protective factors against teen pregnancy, however, a large proportion of Latino youth were disengaged from school. (Uriburu & Kattar, 2006).

33. Making Sexuality Education Culturally Appropriate

34. Effective Strategies for Latinos • Must consider acculturation process. • Traditional values vs. mainstream American values. • Conflict between traditional expectations and the expectations of their non-Latino’s peers. • Must consider language of both teens and parents. • Some Latino teens will feel more comfortable discussing sensitive topics such as sexuality in Spanish. • Recent immigrants would feel more comfortable discussing sensitive topics in Spanish. • Health/sexual educator must be bilingual and bicultural.

35. Effective Strategies for Latinos • Recognize and Respect Cultural Values • Importance of the family – nuclear and extended. • Importance of marriage & virginity. • Role of religious beliefs. • The Gender Role Dynamics • Males and fatherhood. • Females and sexual expression.

36. Effective Strategies for Latinos • Emphasis on Education and Support of High Aspirations. • Latino teens connecting to school is an important step. • Education now, family later. • Parents and Family Involvement • Educate Latino parents on sexual education. • Educate Latino parents, both father and mother, on communication skills.

37. Questions?Thank You!