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IMPLICATIONS OF MEASURES OF HISPANIC ETHNICITY FOR STD PREVENTION AND TRANSMISSION Mary B. Adam, MD and the Informatics and Decision Making Laboratory, University of Arizona College of Medicine How do you measure ethnicity? Skin color/race Country of birth/continent of origin Parents/Grandparents national origin Surname/name analysis Self perception Shared language Hispanic Origin Form US Census 2000 “NO” Box if Not Spanish/Hispanic/Latino No, Not Spanish/Hispanic/Latino Yes, Mexican, Mexican American, Chicano Yes, Puerto Rican Yes, Cuban Yes, Other Spanish/ Hispanic/Latino______ _____________, Salvadoran, Dominican etc Heterogeneity in Hispanic Populations Recent immigrant-legal/illegal Family could have lived in this region for hundreds of years and under several different flags English speakers Spanish speakers Retain strong ties with country of origin or may had adopted attitudes values and beliefs of the dominant culture. NIH Project Aims: (1) to evaluate measures of Hispanic Ethnicity (Phase I) (2) to measure differences in sexual beliefs/values/attitudes in Hispanic versus Anglo teens and in high risk versus low risk teens (Phase I). (3) To measure differences in reasons for risky sexual decisions in Hispanic versus Anglo teens and in high risk and low risk teens (Phase I) (4) to use the data from (1) and (2) in a new curriculum for reducing and avoiding sexual risk in teens (Phase II). Measures of Hispanic Ethnicity Self-reported Ethnicity Subjects birth country Parent’s and Grandparent's birth country Language Use Scales Religion Description of sample 255 Adolescents age 14-19 Gender – 45% male; 55% female Ethnicity – 45% Mexican American/Hispanic – 40% Anglo – 14% Mixed ethnicity – 1% Black – <1% Central/South American – <1%Native American – <1% Asian Description of Sample Anglo – – – – 98% 99% 27% 16% speak English Born in the United States Protestant Catholic – – – – 41% 78% 18% 70% speak English, 20% speak Spanish born in the United States Protestant Catholic Hispanic Factor Analysis Language Use Country born Spanish media Religion importance Self born Catholic/nonCatholic 54% variance 8% variance 6% variance 6% variance 4% variance 3% variance Hierarchical Cluster Analysis Generation born English language use Spanish language use Rates of Sexual Activity by Gender and Ethnicity 49% of males reported sexual activity 49% of females reported sexual activity 48% of Anglos reported sexual activity 44% of Hispanics reported sexual activity Rates of Sexual Activity by Country of Birth 38% of foreign born Hispanics reported being sexually active 48% of US born Hispanics reported being sexually active 48% of US born Anglos reported being sexually active. Rates of Sexual Activity by Language Use: How often do you speak Spanish in general? 34% of Hispanics who “almost always” spoke Spanish were active 45% of Hispanics who “often” or “sometimes” spoke Spanish were active 55% of the Hispanics who reported “almost never” were sexually active Rates of Sexual Activity by Religious Affiliation 40% of Catholics reported being sexually active 54% of non Catholics reported being sexually active Individuals within ethnic groups are not homogenous in their beliefs, values, experiences, or behavior. Culture vs Context Family structure Availability of family members Social economic status Educational attainment Discrimination Access to health care Language barriers Religiosity Perceptions about illness, treatment, physician-patient roles Value of maternal role Acculturation