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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

The Socioecology of Sexual and Reproductive Health Care Use Among Young Urban Minority Males

TitleThe Socioecology of Sexual and Reproductive Health Care Use Among Young Urban Minority Males
Publication TypeJournal Article
Year of Publication2017
AuthorsMarcell, AV, Morgan, AR, Sanders, R, Lunardi, N, Pilgrim, NA, Jennings, JM, Page, KR, Loosier, PS, Dittus, PJ
JournalJ Adolesc Health
Volume60
Pagination402-410
Date PublishedApr
ISBN Number1054-139x
Accession Number28065520
Keywordsaccess to care, Barriers to care, Male adolescents, Sexual and reproductive health care use, Young adult men
Abstract

PURPOSE: To explore perceptions of facilitators/barriers to sexual and reproductive health (SRH) care use among an urban sample of African-American and Hispanic young men aged 15-24 years, including sexual minorities. METHODS: Focus groups were conducted between April 2013 and May 2014 in one mid-Atlantic U.S. city. Young men aged 15-24 years were recruited from eight community settings to participate in 12 groups. Moderator guide explored facilitators/barriers to SRH care use. A brief pregroup self-administered survey assessed participants' sociodemographics and SRH information sources. Content analysis was conducted, and three investigators independently verified the themes that emerged. RESULTS: Participants included 70 males: 70% were aged 15-19 years, 66% African-American, 34% Hispanic, 83% heterosexual, and 16% gay/bisexual. Results indicated young men's perceptions of facilitators/barriers to their SRH care use come from multiple levels of their socioecology, including cultural, structural, social, and personal contexts, and dynamic inter-relationships existed across contexts. A health care culture focused on women's health and traditional masculinity scripts provided an overall background. Structural level concerns included cost, long visits, and confidentiality; social level concerns included stigma of being seen by community members and needs regarding health care provider interactions; and personal level concerns included self-risk assessments on decisions to seek care and fears/anxieties about sexually transmitted infection/HIV testing. Young men also discussed SRH care help-seeking sometimes involved family and/or other social network members and needs related to patient-provider interactions about SRH care. CONCLUSIONS: Study findings provide a foundation for better understanding young men's SRH care use and considering ways to engage them in care.