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Access to comprehensive contraceptive services for youth is essential to improving sexual and reproductive health. However, youth in many countries still face substantial obstacles to contraceptive access and use. The purpose of this study is to compare the contraceptive access experiences and perspectives of pregnant and parenting Mexican-origin youth in Guanajuato, Mexico, and Fresno County, California. Focus groups and in-depth interviews were conducted in Spanish and English among female youth in Mexico (n = 49) and California (n = 25). Participants also completed a brief sociodemographic survey. Using a modified grounded theory approach, qualitative data were coded and thematically analysed based on Penchansky and Thomas's Theory of Access, and results were compared by location. Although knowledge of a service provider was high among youth in both locations, access was affected by social, cultural, and institutional dynamics and contraceptive use was mixed. Across locations, participants described obstacles to accessing their preferred method. Participants worried about parental and peer opinions about their use of contraception (acceptability), and about perceived side effects including infertility and pain (adequacy). Contextual differences included lack of contraceptive choice in Guanajuato (availability) and incomplete knowledge about options in Fresno County (awareness). The power to request and receive their method of choice (agency) emerged as an important dimension that was not part of the original theory. Latina youth living in Mexico and the United States face multiple challenges accessing needed contraceptive options and services. Recognising and reducing these barriers can strengthen the contraceptive care landscape and promote the reproductive health and agency of young people. DOI: 10.1080/26410397.2023.2216527Plain language summary: Although sexually active youth need access to comprehensive sexual and reproductive health services, youth in many countries face substantial barriers to care. This study compares the experiences of pregnant and parenting youth in accessing contraceptive services in Mexico and the United States. We conducted interviews and focus groups with 74 Mexican-origin young women and found that contraceptive use and access was affected by their concerns about parental and peer opinions as well as by provider attitudes. In Mexico, several participants reported being denied their preferred method by their provider. Identifying and addressing barriers to services can improve the quality of care and the reproductive health of young people.

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BACKGROUND: Although there is growing recognition of the importance of person-centered maternity care, the needs and perspectives of pregnant adolescents are rarely considered. The purpose of this study was to compare the maternity care experiences of Mexican-origin adolescents in Guanajuato, Mexico and Fresno, California from both youth and healthcare provider perspectives. METHODS: Qualitative interviews and focus groups were conducted with a total of 89 respondents, including 74 pregnant and parenting adolescents as well as 15 providers between December 2016 and July 2017. Adolescents also completed a short demographic survey prior to participation. Transcripts in English and Spanish were coded and thematically analyzed using Dedoose software. Results were compared by location and between youth and providers. RESULTS: Four themes emerged regarding patient-provider interactions: the need for communication and clear explanations, respectful versus judgmental providers, engaging youth in decision-making, and a focus on the age of the youth and their partners. While youth had similar perspectives and priorities in both locations, youth in Mexico reported more negative healthcare experiences than youth in California. Perspectives varied between the youth and providers, with providers in both California and Mexico identifying several structural challenges in providing quality care to adolescents. In California, challenges to supporting immigrant Latina adolescents and their families included language and translation issues as well as barriers to care due to immigration status and documentation. In both locations, providers also mentioned high patient caseloads and their own concerns about the youth's life choices. CONCLUSION: Youth-centered care requires more effective and respectful patient-provider communication, where adolescents are engaged in their healthcare decision-making and delivery options. Changes in patient-provider interactions can help improve the maternity care experiences and outcomes of Latina adolescents. Healthcare systems and providers need to reconfigure their approaches to focus on the needs and priorities of adolescents.

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Teenage birth rates among young people aged 15-19 years in California, USA, have declined from 47 births per 1000 in 2000 to 24 per 1000 in 2013. Nevertheless, the US counties with the highest teenage birth rates are predominantly rural and have a high proportion of Latinos/as. We conducted 42 interviews with key stakeholders and 12 focus groups with 107 young people in five rural communities to better understand local migration patterns and their influence on intermediate and proximate variables of pregnancy, such as interaction with role models and barriers to access contraception. The migration patterns identified were: residential mobility due to seasonal jobs, residential mobility due to economic and housing changes and migration from other countries to California. These patterns affect young people and families' interactions with school and health systems and other community members, creating both opportunities and barriers to prevent risky sexual behaviours. In rural areas, residential mobility and migration to the USA interconnect. As a result, young people dually navigate the challenges of residential mobility, while also adapting to the dominant US culture. It is important to promote programmes that support the integration of immigrant youth to reduce their sense of isolation, as well as to assure access to sexual health education and reproductive health services.

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An appreciation of the social, cultural and economic dimensions of gender and sexuality is important in increasing reproductive health service utilisation. This analysis of recent Mexican male immigrants in Southern California focuses on changing views of gender roles, masculinity and relationship dynamics in the context of migration in order to explain low levels of reproductive healthcare utilisation. Semi-structured, in-depth interviews were conducted with 23 men who had migrated from Mexico. Some men saw their migratory experience as empowering, both individually and within the couple context. Migration reinforced positive male qualities, such as being a good provider. However, for others, the levelling of economic power between immigrant couples challenged traditional male gender roles and threatened men's identities. Maintaining control and decision-making power, especially in reproduction, remained tenacious, especially among older men. In response to immigration, however, men's views of ideal family size and contraceptive method preferences had evolved. The migration process caused some divisions in family networks and aspirations of fatherhood as an expression of masculinity contributed to varying levels of contraceptive use. Recommendations are made on factors that may empower male clients more actively to seek reproductive healthcare in the context of more equitable couple decision-making.

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INTRODUCTION: Mexican immigrant status has been associated with decreased obesity, but this pattern may be changing. We draw from 2001-2006 NHANES data on Mexican Americans to examine whether body mass index (BMI) and waist circumference vary by country of birth and among the U.S.-born by language. RESULTS: Among women, U.S.-born Spanish speakers had the highest mean BMI, followed by immigrant women, while U.S.-born English speakers had the lowest mean BMI. Immigrant men had a lower mean BMI than U.S.-born men. These patterns were similar for waist circumference and persisted after adjusting for socioeconomic status (SES) and other covariates. CONCLUSION: Immigrant women do not appear to be protected against a large body size, compared with immigrant men. Among the U.S.-born, women who retain Spanish are at higher risk for larger body size than exclusive English speakers. Initiatives targeting obesity should address differentials in body size patterns among immigrant and U.S.-born Mexican American men and women.

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This study of the experiences of recent Mexican immigrants living in California explores the changing perceptions of sexual and societal norms, including gender roles and resulting reproductive decision-making, that appear to accompany the migration process. These norms are compared to those held by migrants' families of origin in Mexico. We analysed 44 semi-structured interviews conducted with a client-based population in order to identify reproductive perceptions and practices that appear to be influenced by recent migration. Using a grounded theory approach, 26 women and 18 men's narratives were analysed to understand the complexity of changing expectations and resulting reproductive health practises. The social marginalisation and isolation of immigrants' experiences, the challenges of new socio-economic factors and access to health services appear to reshape views on reproductive decisions. While traditional gender roles and large families remain a spoken ideal, in practice these reproductive patterns are changing. Our analysis suggests that the migration process does alter relationships, reproductive decisions and contraceptive use among recent Mexican immigrants. The public health goal should be to provide an array of accessible and affordable services, tailored to the needs of this increasingly larger population of recent Mexican migrants in California and throughout the USA.

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This article analyzes intimate partner violence (IPV) against women aged 15 to 21, 30 to 34, and 45 to 49, based on the 2003 National Survey on the Dynamics of Household Relationships (in Spanish, ENDIREH) in Mexico. The authors examined the degree of women's empowerment and autonomy in relation to their partners. Logit regression analyses showed that variables significantly associated with physical violence varied between the three age groups, suggesting that women followed specific trajectories throughout their reproductive lives. Some dimensions of empowerment reduced the risk of violence (women's ability to decide whether to work, when to have sexual relations, and the extent of their partners' participation in household chores). Other dimensions (women's decision making regarding reproductive matters) increased such risk. Thus, access to resources meant to empower women did not automatically decrease the risk of violence. The authors recommend specific interventions tailored to each age group, aimed at breaking the cycle of violence.

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Identificar las diferencias y similitudes en cuanto a conocimiento, actitudes y comportamientos sexuales y de antinconcepción entre los estudiantes adolescentes latinos que vivem en California y en Lima. Estudiantes adolescentes varones latinos de 12-19 años completaron las encuestas anónimas, autoaplicables tanto en California como en cuatro colegios secundarios en Lima. Ambas encuestas contenían preguntas con respecto a actividad sexual y comportamiento de anticoncepción. La media de edade fue de 16 y 15 años, respectivamente. Más varones adolescentes en California señalaron haber tenido relaciones coitales (69 por ciento vs 43 por ciento). Entre éstos, la media de edade de inicio sexual fue de 13 años en ambas muestras. Más estudiantes en California sabian del riesgo de embarazo en la primera relación sexual (82 por ciento vs 50 por ciento). Un tercio de los adolescentes varones de California señalaron que hablar sobre sexo y anticoncepción con su pareja es "fácil", comparados al 53 por ciento de los de Lima. Más estudiantes en California señalaron conocer un lugar para obtener anticonceptivos si ellos los necesitan (85 por ciento vs 63 por ciento), haber embarazado a alguien alguna vez (29 por ciento vs 7 por ciento) y haber tenido un hijo (67 por ciento vs 16 por ciento).

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El objetivo del estudio fue explorar y analizar la interacción en la imformación en sexualidad entre los adolescentes de acuerdo a su propia perpectiva. En la metodología, se realizaron grupos focales en 4 colegios estatales ubicados en un distrito urbano-marginal de la zona norte de Lima, Perú. Por cada colegio se tuvo un grupo focal compuesto por varones y otro por mujeres. Los alumnos participantes tenían entre 13 y 17 años de edad y residían en el distrito donde se ubicaban los colegios. En general los resultados muestran que los adolescentes varones y mujeres relacionan la sexualidad básicamente con el coito y el placer. Por lo tanto, la información que brindan los padres y en general los adultos acerca de la sexualidad sería parcial e incompleta y no satisfacería las expectativas de los adolescentes. Además, ellos limitarían conocer y sentir el "goce y placer sexual". Frente a esto, la pornografía aparece como medio de información alternativo en sexualidad. La pornografía no sólo enseñaría a los padres y las adolescentes el "cómo hacerlo", sino que, además, sería utilizado como estímulo visual sobretodo por los varones para la masturbación y/o el coito

The objective is to explore and analyze the interaction on information in sexuality in adolescents since their own perspective. The methodology of this study was based on 8 focal groups (4 with men and 4 with women) carried out in 4 public high schools located in an urban-marginal district in north of Lima, Peru. The participant students were aged 13 to 17 years old and they lived in the district where the schools were located. The results show that males and women adolescents define the sexualityrelated basically with coitus and pleasure.Therefore, the information given by parents and adults about sexuality to adolescents would be partial and incomplete, and it would not be satisfactory for adolescents' expectations; in addition, they would limit them to know and to feel the sexual enjoyment and pleasure. Because of the absence of information about the enjoyment and sexual pleasure, pornography appears as an alternative means of information in sexuality. Also, the pornography would be used as visual stimulus, mainly for men, for the masturbation and / or the coitus

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El embarazo en las adolescentes conlleva a una serie de consecuencias y secuelas diferenciadas por género y la prevención del mismo debe estar vinculado a la perspectiva de los propios adolescentes. La población estuvo constituida por estudiantes adolescentes de 4 colegios secundarios en un distrito pobre al norte de Lima, Perú. Se realizaron 8 grupos focales con 8 adolescentes por grupo (4 de mujeres y 4 de varones) entre los 13 y 17 años, residentes en la zona, dos por cada colegio. Tanto los adolescentes varones como las mujeres, se atribuyen mutualmente la responsabilidad de asumir comportamientos sexuales para la prevención de embarazos. Mas aun, se encontró que el significado social de ser mujer o ser hombre impediría la negociación de uso métodos anticonceptivos al momento de tener relaciones sexuales. Por otro lado, los métodos anticonceptivos, particularmente el preservativo, está rodeado de falsas creencias y expectativas que restringirían su uso. Las restrinciones impuestas por los/las propio(a)s adolescentes al uso del preservativos, también se generaliza a los otros métodos anticonceptivos, particularmente los hormonales. Estas actitudes están siendo reforzadas indirectamente por el entorno social, pues tanto los padres, profesores y en general la comunidad, restringirían el acceso a información, optando ellos/ellas por otras fuentes que desinforman como los medios masivos y otros como videos o revistas pornográficos. La aproximación de género en los estudios cualitativos en sexualidad permite distinguir los diferentes puntos de vista de los/las adolescentes sobre la prevención del embarazo no planeado negociando los métodos anticonceptivos

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Con el objetivo de documentar el nivel de conocimiento y las actitudes con respecto a sexualidad y las prácticas sexuales de los adolescentes varones de colegios secundarios en Lima, Peru, 991 estudiantes varones, entre los 12-19 años, completaron una encuesta autoaplicable y anónima dentro de un Programa de Prevención de Comportamientos Sexuales de Riesgo. Datos de la encuesta: sociodemográficos de la familia; de actividades personales; de conocimiento y actitudes con respecto a la sexualidad; de experiencia sexual y uso de anticonceptivos. El conocimiento sobre sexualidad es limitado. Los varones discuten principalmente sobre sexualidad con sus pares varones (49,8 por ciento). Las actitudes hacia la actividad sexual y el uso de condones fueron positivas, pero algunos expresaron sentimientos ambivalentes en cuanto a su uso. El 43 por ciento había tenido relaciones coitales alguna vez y la edad promedio del inicio sexual fue de 13 años. Mientras que el 88 por ciento de la muestra usaría condones, el 74 por ciento también dio razones para no usarlos. La actividad sexual se asoció a la edad, a haber repetido un grado, a vivir con uno de los padres o con una famila re-estructurada, con actividades como ir a fiestas, uso de alcohol, tabaco y drogas, y ver revistas o videos pornográficos. Muchos de los adolescentes varones estuvieron en riesgo de ocasionar un embarazo no planeado o adquirir una ETS.

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Objetivo: identificar el nivel de conocimiento y las actitudes sobre sexualidad y las prácticas sexuales de las estudiantes adolescentes en colegios secundarios de Lima, Perú. Material y métodos: fue una encuesta anónima y auto-administrada fue completada por 935 mujeres de 12-19 años como parte de un modelo de intervención sobre educación sexual en colegios secundarios. las preguntas cubrierón 6 áreas: información socio-demográficas, características de sus familias, actividades personales, actitudes y conocimientos en sexualidad fue limitado (media igual 9.9) al ser medido a través de 20 preguntas básicas. Las mujeres conversaban más sobre sexualidad con sus madres (43 por ciento) y con sus pares mujeres (41 por ciento). Las actitudes con respecto a la sexualidad y la acticoncepción fueron positivas pero algunas son ambivalentes con respecto al uso de anticonceptivos. El 8 por ciento de la muestra ya ha tenido relaciones coitales y la edad del primer coito fue de 14 años. Mientras que el 63 por ciento de las estudiantes usaría la píldora, el 74 por ciento, también, dió razones para no usarla. La actividad sexual se relacionó a la edad, si repitió de grado, si habla sobre sexualidad con el enamorado o amigo, si sus razones para tener relaciones coitales con "por placer o diversión", si ha tenido enamorado y si ha tenido más de 2 enamorados. Conclusión: las estudiantes adolescentes en esta muestra tienen un conocimiento limitado en sexualidad y anticoncepción, actitudes ambivalentes en el uso de anticonceptivos, aunque ellas estuvieran en riesgo de un embarazo no planeado o de adquirir una ETS. estos hallazgos señalan la necesidad de modelos de intervención en colegios y comunidades dirigidos a reducir las actitudes ambivalentes y los comportamientos de riesgo entre las adolescentes con un uso consistente y correcto de los anticonceptivos.

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