Disparities in contraceptive knowledge, attitude and use between Hispanic and non-Hispanic whites

Abstract

Background Higher rates of unwanted pregnancies and lower rates of contraceptive use have been reported among Hispanic women than among non-Hispanic whites. Despite these differences, it is unclear how these groups differ with respect to various psychosocial factors that are associated with contraceptive decision making, including contraceptive knowledge, attitudes, self-efficacy and social support. Methods A total of 443 sexually active, nonpregnant, low-income women (137 non-Hispanic whites, 74 US-born Hispanics and 231 non-US-born Hispanics) were surveyed at two publicly funded clinics. Results The greatest number of barriers to the effective use of contraception was seen among non-US-born Hispanic women. Fewer differences emerged between US-born Hispanics and whites, although differences continued to exist between the two groups in certain key areas. As compared to non-Hispanic whites, US-born Hispanic women had lower levels of social support for and self-efficacy in contraceptive use, desired larger families, had more religious objections to using birth control and were more those likely to believe that birth control use is the responsibility of women. As compared to whites, both US and non-US-born Hispanic women had significantly lower rates of ever-use of contraceptives that are highly effective in preventing pregnancy or in preventing disease transmission, and higher rates of unintended pregnancies. All associations were independent of known confounders. Conclusion Despite improvements in contraceptive knowledge and attitude, birth control and disease-preventive practices did not improve significantly among Hispanics who were born in the United States. Hispanic women are at higher risk for unintended pregnancy than are non-Hispanic whites, irrespective of their US nativity.