Receipt of STD Testing, HIV Testing, and Sexual and Reproductive Health Care by Hispanic Youth: Associations with Generation of Immigration and Acculturation

Background: The extent to which generation of immigration (GI) or acculturation may affect the receipt of sexual and reproductive health care (SRHC) services, STD, and HIV testing among Hispanic youth is unclear.

Objectives: To compare the influence of GI and acculturation on lifetime incidence of receipt of STD or HIV testing, or SRHC services among Hispanic youth.

Methods: Data were collected from students in 12 public high schools in the Los Angeles, CA area. Respondents indicated whether they had ever been tested for STD, for HIV, or received any of 3 SRHC services. GI was defined as: 1^st generation, child/parents foreign-born; 2^nd generation, child US-born, one/both parents foreign-born; and 3^rd generation, parents/child US-born. Acculturation was based on language spoken at home: English only, English/Spanish, or Spanish only. Logistic regression was used to predict receipt of services based on acculturation, GI, and sexual activity, controlling for age and gender.

Results: Compared to English only, STD/HIV testing and receipt of SRHC services were significantly less likely (28%, 35%, and 16% respectively) to occur if only Spanish was spoken in the home; HIV testing was 26% less likely if both English and Spanish were spoken. Compared to 3^rd generation youth, 1^st generation youth were 34% more likely to receive HIV testing; GI did not affect STD testing or SRHC services. Females, older youth, and sexually experienced youth were more likely to have received HIV/STD testing and SRHC services.

Conclusions: Receipt of STD and HIV testing and SRHC services is lower for Hispanic youth if Spanish was spoken exclusively in the home. This marker for acculturation was a more pervasive barrier than GI.

Implications for Programs, Policy, and/or Research: Hispanic youth are in need of SRHC services. Youth who live in homes where Spanish is spoken exclusively should be targeted for outreach to improve access to SRHC services.