The socioecology of sexual and reproductive health care use among young urban minority males

Post Date: 
Journal of Adolescent Health

Purpose: To explore perceptions of facilitators/barriers to sexual and reproductive health (SRH) care use among an urban sample of African-American and Hispanic young men aged 15-24 years, including sexual minorities.


Methods: Focus groups were conducted between April 2013 and May 2014 in one mid-Atlantic U.S. city. Young men aged 15-24 years were recruited from eight community settings to participate in 12 groups. Moderator guide explored facilitators/barriers to SRH care use. A brief pregroup self-administered survey assessed participants' sociodemographics and SRH information sources. Content analysis was conducted, and three investigators independently verified the themes that emerged.


Results: Participants included 70 males: 70% were aged 15-19 years, 66% African-American, 34% Hispanic, 83% heterosexual, and 16% gay/bisexual. Results indicated young men's perceptions of facilitators/barriers to their SRH care use come from multiple levels of their socioecology, including cultural, structural, social, and personal contexts, and dynamic inter-relationships existed across contexts. A health care culture focused on women's health and traditional masculinity scripts provided an overall background. Structural level concerns included cost, long visits, and confidentiality; social level concerns included stigma of being seen by community members and needs regarding health care provider interactions; and personal level concerns included self-risk assessments on decisions to seek care and fears/anxieties about sexually transmitted infection/HIV testing. Young men also discussed SRH care help-seeking sometimes involved family and/or other social network members and needs related to patient-provider interactions about SRH care.


Conclusions: Study findings provide a foundation for better understanding young men's SRH care use and considering ways to engage them in care.

Marcell AV, Morgan AR, Sanders R, Lunardi N, Pilgrim NA, Jennings JM, Page KR, Loosier PS, Dittus PJ. The socioecology of sexual and reproductive health care use among young urban minority males. J Adolesc Health. 2017 Jan 5. pii: S1054-139X(16)30867-9. doi: 10.1016/j.jadohealth.2016.11.014. [Epub ahead of print] PMID: 28065520

  • Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD

  • Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

  • Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA