Adolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey

Abstract Background Adolescents may forego needed sexual and reproductive health (SRH) services due to a variety of concerns and barriers. The purpose of this study is to compare adolescents’ perceptions of these barriers by participant characteristics including race/ethnicity, gender, sexual orient...

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Autores principales:	Martha J. Decker, Tara V. Atyam, Catherine Gilmore Zárate, Angela M. Bayer, Consuelo Bautista, Melissa Saphir
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Adolescents Sexual health Sex education Reproductive health services California Barriers to care Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/a6b977809a654d1ca7ca5d65726877e0
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spelling	oai:doaj.org-article:a6b977809a654d1ca7ca5d65726877e02021-11-28T12:07:55ZAdolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey10.1186/s12913-021-07278-31472-6963https://doaj.org/article/a6b977809a654d1ca7ca5d65726877e02021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07278-3https://doaj.org/toc/1472-6963Abstract Background Adolescents may forego needed sexual and reproductive health (SRH) services due to a variety of concerns and barriers. The purpose of this study is to compare adolescents’ perceptions of these barriers by participant characteristics including race/ethnicity, gender, sexual orientation, housing situation, and sexual experience. Methods Adolescents in a California-wide sexual health education program completed an anonymous survey at baseline (N = 10,015) about perceived barriers to using SRH services. Logistic regression analyses that accounted for the clustered data structure assessed differences by gender, age, sexual orientation, race/ethnicity, living situation, and sexual experience. Results The majority of participants were Hispanic/Latino (76.4%) with an average age of 14.9 years, and 28.8% had sexual experience. Half of the youth reported concerns about test results (52.7%), cost of services (52.0%), and confidentiality of services (49.8%). When controlling for other characteristics, youth identifying as transgender/non-binary/multiple genders had the highest odds of perceiving cost (odds ratio (OR) 1.89) and confidentiality (OR 1.51) as barriers. Increasing age was associated with decreasing odds of all barriers. Sexual orientation was a consistent predictor, with LGBQ+ youth having higher odds of perceiving test results (OR 1.21), cost (OR 1.36), and confidentiality (OR 1.24) as barriers. Asian or Pacific Islander/Native Hawaiian youth had higher odds of perceiving test results (OR 1.68) and cost (OR 1.37) as barriers. In contrast, Black youth had lower odds of reporting cost (OR 0.65) and confidentiality (OR 0.77) as barriers. Younger respondents and youth who identified as female, transgender/non-binary/multiple genders, LGBQ+, and Asian or Pacific Islander/Native Hawaiian had higher odds of reporting five or more barriers compared to reference groups. Conclusions The majority of adolescents face barriers to accessing appropriate SRH services, with females, gender-minority youth, younger adolescents, LGBQ+ youth, and Asian and Pacific Islander/Native Hawaiian youth more likely than others to report barriers. Access to SRH services can be improved through strengthening linkages between clinics and SRH education programs, providing youth-friendly clinical services, and ensuring youth have sufficient information, skills, and support to access care. Trial registration Approved by California Health and Human Services Agency’s Committee for the Protection of Human Subjects [12-08-0658, 11/30/2017].Martha J. DeckerTara V. AtyamCatherine Gilmore ZárateAngela M. BayerConsuelo BautistaMelissa SaphirBMCarticleAdolescentsSexual healthSex educationReproductive health servicesCaliforniaBarriers to carePublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Adolescents Sexual health Sex education Reproductive health services California Barriers to care Public aspects of medicine RA1-1270
spellingShingle	Adolescents Sexual health Sex education Reproductive health services California Barriers to care Public aspects of medicine RA1-1270 Martha J. Decker Tara V. Atyam Catherine Gilmore Zárate Angela M. Bayer Consuelo Bautista Melissa Saphir Adolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey
description	Abstract Background Adolescents may forego needed sexual and reproductive health (SRH) services due to a variety of concerns and barriers. The purpose of this study is to compare adolescents’ perceptions of these barriers by participant characteristics including race/ethnicity, gender, sexual orientation, housing situation, and sexual experience. Methods Adolescents in a California-wide sexual health education program completed an anonymous survey at baseline (N = 10,015) about perceived barriers to using SRH services. Logistic regression analyses that accounted for the clustered data structure assessed differences by gender, age, sexual orientation, race/ethnicity, living situation, and sexual experience. Results The majority of participants were Hispanic/Latino (76.4%) with an average age of 14.9 years, and 28.8% had sexual experience. Half of the youth reported concerns about test results (52.7%), cost of services (52.0%), and confidentiality of services (49.8%). When controlling for other characteristics, youth identifying as transgender/non-binary/multiple genders had the highest odds of perceiving cost (odds ratio (OR) 1.89) and confidentiality (OR 1.51) as barriers. Increasing age was associated with decreasing odds of all barriers. Sexual orientation was a consistent predictor, with LGBQ+ youth having higher odds of perceiving test results (OR 1.21), cost (OR 1.36), and confidentiality (OR 1.24) as barriers. Asian or Pacific Islander/Native Hawaiian youth had higher odds of perceiving test results (OR 1.68) and cost (OR 1.37) as barriers. In contrast, Black youth had lower odds of reporting cost (OR 0.65) and confidentiality (OR 0.77) as barriers. Younger respondents and youth who identified as female, transgender/non-binary/multiple genders, LGBQ+, and Asian or Pacific Islander/Native Hawaiian had higher odds of reporting five or more barriers compared to reference groups. Conclusions The majority of adolescents face barriers to accessing appropriate SRH services, with females, gender-minority youth, younger adolescents, LGBQ+ youth, and Asian and Pacific Islander/Native Hawaiian youth more likely than others to report barriers. Access to SRH services can be improved through strengthening linkages between clinics and SRH education programs, providing youth-friendly clinical services, and ensuring youth have sufficient information, skills, and support to access care. Trial registration Approved by California Health and Human Services Agency’s Committee for the Protection of Human Subjects [12-08-0658, 11/30/2017].
format	article
author	Martha J. Decker Tara V. Atyam Catherine Gilmore Zárate Angela M. Bayer Consuelo Bautista Melissa Saphir
author_facet	Martha J. Decker Tara V. Atyam Catherine Gilmore Zárate Angela M. Bayer Consuelo Bautista Melissa Saphir
author_sort	Martha J. Decker
title	Adolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey
title_short	Adolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey
title_full	Adolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey
title_fullStr	Adolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey
title_full_unstemmed	Adolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey
title_sort	adolescents’ perceived barriers to accessing sexual and reproductive health services in california: a cross-sectional survey
publisher	BMC
publishDate	2021
url	https://doaj.org/article/a6b977809a654d1ca7ca5d65726877e0
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Adolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey

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