Making Sexuality Education and Prevention Programs Relevant for African-American Youth
Pittman, Karen J., Wilson, Pamela M., Adams-Taylor, Sharon, Randolph, Suzanne, Journal of School Health
In 1990, 5,493,000 African-American youth between the ages of 10 and 19 were living in the United States, representing 16% of the total U.S. youth population and 17.6% of the total African-American population. By the year 2030, nearly 18% of all young people in this country will be of African-American descent. (1) Demographic statistics alone demonstrate the importance of designing appropriate and effective strategies to reach, teach, and provide counseling and reproductive health services to African-American youth. No prevention strategy can be effective if it fails to reach such a large and growing segment of its target population.
Data on the reproductive behaviors of African-American youth, however, suggest the absolute urgency of assessing the reach and effectiveness of current strategies:
* In 1988, African-American women ages 15-19 continued to have the highest rates (61%) of sexual activity compared to 49% for Hispanics and 52% for Whites. While the rate of sexual activity increased significantly from 1982 to 1988 for White teens, it increased only slightly for African-American teens. (2)
* Teen-age African-American males are significantly more likely to report younger ages at first intercourse than White or Hispanic teens; 20% report first intercourse before age 13 and 35% had intercourse at least once before age 14. (3)
* In 1988, 58% of sexually active African-American females ages 15-19 reported having had sex with two or more partners; nearly one in four have had sex with four or more partners. Among 18- to 19-year-old sexually active males, one in two report multiple partners in a one-year period. (2)
* African-American and Hispanic teens are less likely than White teens to use any contraceptive method at first intercourse. (2)
* In 1988, African-American teens were twice as likely to become mothers as their White counterparts. Thirty percent of births to African-American teens were repeat births. Ninety-two percent of African-American teens who gave birth were single at the time of birth. (4)
* Younger African-American teens are at particular risk of early parenthood. In 1988, nearly six of 10 births (58.4%) to teens younger than age 15 were to African-American teens. (4)
* A 1990 Centers for Disease Control report revealed that 52% of children under age 14 who have AIDS are African-American. (5)
Reports of statistics by ethnic group are undoubtedly inflammatory because of the confounding relationship between socioeconomic status and ethnicity. Early sexual intercourse, early parenthood, and STD infection are all more prevalent among low-income populations than among those more affluent. Nonetheless, the data represent a fraction of the indicators of the present status of adolescent health outcomes among African-American youth. The good news is that demographics do not necessarily dictate destiny. Despite the litany of difficulties and disparities faced by African-American youth, many remain resilient, focused, and goal-oriented.
Data also suggest the need to assess the appropriateness of current prevention efforts on two distinct levels:
* At the program level, the appropriateness and effectiveness of both the content and adult/youth interaction must be examined. Are materials culturally relevant? Are realistic attitudinal and behavioral changes being espoused and/or accepted among African-Americans in general and African-American youth in particular? Are statements or behaviors of either the youth or the adult leaders likely to be misread or misunderstood because of unfamiliarity with cultural styles and values? Are assumptions about the ability and willingness of young African-Americans to increase their knowledge and skills appropriate?
* At the policy level, there is a need to assess, and probably adjust, assumptions about the relative priority attached to primary vs. secondary vs. …