The Relationship between Barriers to Birth Control Use and Actual Birth Control Use among Mexican-American Adolescents

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ABSTRACT

This study examined the relationship between barriers to using birth control and actual use of birth control among a national sample of Mexican-American adolescents. Participants were either over age 15 or sexually active (regardless of age). They responded to survey items on birth control use. Chi-square analysis and t tests were used to investigate whether barriers to using birth control were related to actual use during first intercourse and most recent sexual intercourse. It was found that nonusers had significantly higher barrier scores compared with users of birth control. The results indicate that attitudes toward birth control are associated with actual birth control use among Mexican-American adolescents. Additionally, males and females may have distinct barriers to using birth control. It was concluded that a better understanding of the sexual attitudes and beliefs associated with birth control is needed in order to improve programs seeking to increase the use of birth control among this rapidly exp anding, high-risk population.

Between 1990 and 1993, Hispanics surpassed African-Americans as the group with the highest adolescent birthrate (Alan Guttmacher Institute, 1994). Further, the birthrate among Mexican-American adolescents is higher than that of any other Hispanic group (Centers for Disease Control, 1993; Alan Guttmacher Institute, 1994). Interestingly, Mexican-Americans have a higher rate of early childbearing, as compared with Anglos, despite having a lower rate of early sexual intercourse (Aneshensel, Fielder, & Becerra, 1990; De Anda, Becerra & Fielder, 1988).

Various explanations have been offered for the high rate of adolescent pregnancy among Hispanics, and Mexican-Americans in particular. It should first be noted that, in a national sample, 62% of Hispanic males reported being sexually active compared with 49% of Anglo males, while 53% of Hispanic females reported sexual activity compared with 49% of Anglo females (Warren, Santelli, Everett, Kann, Collins, Cassell, Morris, & Kolbe, 1998). Second, compared with non-Hispanics, Hispanics have been found to be less knowledgeable about birth control and sexually transmitted diseases, including HIV (Council on Scientific Affairs, 1991). Erickson (1998) has stated that, "compared to Anglo and African-American teens, Latina teens know less about birth control and are less likely to use birth control at first intercourse, and have lower rates of birth control use overall" (p. 129). It therefore stands to reason that sexual activity combined with ignorance about, and negative attitudes toward, birth control would contri bute to high pregnancy rates among Hispanic adolescents.

Hispanic adolescents are less likely than Anglos or African-Americans to contact health care providers for routine care, including birth control (Lieu, Newacheck, & McManus, 1993). In light of this, it is not surprising that Hispanic adolescents are less likely than Anglos and African-Americans to use birth control (Piccinino & Mosher, 1998; Mauldon & Luker, 1996; Hodges, Leavy, Swift, & Gold, 1992; Mosher & McNally, 1991; Aneshensel et al., 1989). Further, Mexican-Americans are less likely than Cubans, Puerto Ricans, and other Hispanic adolescents to use birth control (DuRant, Seymore, Pendergrast, & Beckman, 1990).

Research with adolescents has identified various barriers to birth control use. Embarrassment about purchasing birth control and overall inconvenience have been cited by adolescents as barriers to use (Murphy & Boggess, 1998; Bernard & McKeganey, 1990). An adolescent who believes that birth control methods are likely to interfere with sexual pleasure is less likely to report use (Murphy & Boggess, 1998; Joffe & Radius, 1993; Pleck, Sonenstein, & Ku, 1993; Skurnick, Johnson, Quinones, Foster, & Louria, 1991). Communication issues between partners (Landry & Forrest, 1995), positive or ambivalent feelings about having a baby (Stevens-Simon, Singer, & Cox, 1996), male ambivalence toward the consistent use of condoms, and perception of stigma in obtaining and carrying condoms among females (Price, 1997) have also been found to be influential. …