Mexico and USA: A Binational Comparison of Attitudes, Beliefs and Knowledge About Sex and Contraception Among Adolescents

Mexican minority majority rural counties in Kansas have in between 4-10 times higher teen pregnancy rates than urban counties with predominantly White Non-Hispanic population. Previous studies showed important cultural influences on attitudes, beliefs and knowledge about sex, family planning and contraception use among Latinos. Our objective is to compare attitudes, beliefs and knowledge about contraception and sexuality in Mexican adolescents living in Kansas to Mexican adolescents living in Hidalgo, Mexico. A theory-based, quantitative study comparing Mexicans in US and Mexico will provide critical foundation for a culturally sensitive implementation dissemination research designed to enhance knowledge and utilization of contraception for youth in rural Latino communities, and ultimately prevent teen pregnancy. This is a descriptive, transversal and exploratory study. Project coordinators recruited 15-24 year old Mexican in Kansas (N =127) and Pachuca, Mexico (N = 226) from schools, to complete an anonymous self-administered survey. Questions assessed demographics, language preferences, reproductive health care access, pregnancy intention, contraceptive methods use and knowledge about different contraceptives. Our cohort in the US was mainly of Mexican origin, 15-18 years old (65%) and although 59% had lived in the US for more than 10 years, 43% of the subjects still spoke only Spanish at home. More than a third (37.6%) of our cohort in the US was sexually active; half of them (54%) had used a condom at last sexual intercourse, and only 5% had used a form of effective hormonal contraception. Subjects in Mexico were mostly younger than 16 years old (80%), sexually active in 6.5% of the cases, and only 17% of the sexually active participants had used a condom at last intercourse, with less than 2% of the subjects using an effective hormonal contraception at last intercourse. Many similarities were found in both samples: their religion (Catholic/Christian 95%); limited access to health and reproductive health care (74.2% in US vs 80.6% in Mexico); pregnancy scare or unplanned pregnancy in a fifth of their participants (20.1% vs 18.3%); thinking they will likely have an unplanned pregnancy while single and that if pregnancy had to happen, it would happen regardless of contraception use (27.3% vs 24.8%). Parents, friends and close family members were main sources of knowledge for contraception on both samples. Similar percentages in both samples (41.2% vs 30.9%) were looking forward to experiences that a baby would bring. More than a third of the subjects had friends with unplanned pregnancy in both samples. Similarities found in Mexican adolescents living in Kansas (US) and their counterparts in Hidalgo (Mexico), highlight the role of acculturation and culture on reproductive health behaviors that can guide the design of teen pregnancy prevention interventions among Latino teens. Culturally sensitive interventions attain better acceptability, inspire greater trust of adolescents and thus, improve adherence.