Acculturation and the Sexual and Reproductive Health Of Latino Youth in the United States: A Literature Review

Authors

  • Aimee Afable-Munsuz,

    1. Aimee Afable-Munsuz is a postdoctoral fellow, and Claire D. Brindis is professor of pediatrics and health policy and associate director, both at the Institute for Health Policy Studies, University of California, San Francisco.
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  • Claire D. Brindis

    1. Aimee Afable-Munsuz is a postdoctoral fellow, and Claire D. Brindis is professor of pediatrics and health policy and associate director, both at the Institute for Health Policy Studies, University of California, San Francisco.
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  • The authors thank Jeanne Tschann and the postdoctoral fellow writing group at the Institute for Health Policy Studies, University of California, San Francisco, for their careful review of early versions of this article. They also thank Sarah Schwartz for her invaluable research assistance, and the Adolescent Reproductive Health Team, Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), for their role in initiating this review. Funding for this work came from the CDC/Association of Teachers of Preventive Medicine cooperative agreement TS-0842. The conclusions and opinions expressed here are those of the authors and not necessarily those of the funder.

Abstract

CONTEXT: The high birthrate among Latina teenagers in the United States has generated increased interest in the role of acculturation in their sexual and reproductive health. It is critical to identify gaps in the existing research and to ascertain the relationship between acculturation and Latino sexual behavior.

METHODS: PUBMED, ERIC and POPLINE were searched for journal articles published between 1985 and 2006 that explicitly examined acculturation and sexual and reproductive health among Latino youth. All fertility-related outcomes (pregnancy, birth, abortion) and their proximate determinants (attitudes, knowledge, norms, sexual activity contraceptive use) were considered sexual or reproductive health outcomes. Eligible studies used a cross-sectional or longitudinal design; had a sample of males, females or both aged 25 or younger; and included Latino-specific analyses.

RESULTS: Seventeen studies met the screening criteria, and these studies used 23 distinct measures of acculturation that captured four primary dimensions: time (duration of exposure to U.S. culture), language, culture and residence. The measures’robustness varied, and none of the studies was widely generalizable. Ten studies investigated sexual initiation, and eight of these found a positive association between the likelihood of this outcome and acculturation. Acculturation also was associated with increased condom use and with beliefs and norms related to healthy outcomes, although the evidence was less conclusive.

CONCLUSIONS: Ideal studies of acculturation would stratify analyses by gender and country of origin, and would include time measures related to acculturation. When feasible, studies should be population-based and longitudinal, and should build on existing theories of the relationship between acculturation and the sexual behavior, norms and beliefs that are unique to Latino culture.

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