Patterns and Disparities in Sexual Health Service Utilization among Adolescent Males: A Report From a National Teen Pregnancy Prevention Initiative

Abstract

Male adolescents have higher rates of risky sexual behaviors compared to females, including earlier age of first sexual intercourse, higher rates of sexual experience, unprotected intercourse, and sex while high on drugs and/or alcohol. However, compared to females, male adolescents are less likely to receive routine primary care, disease screenings, sexual health counseling, and pregnancy prevention service. Although gender disparities in sexual and reproductive healthcare (SRH) have been well documented, there has been little research on racial/ethnic disparities in adolescent male utilization of SRH services. The current report aims to address this gap in research using data from a national initiative to reduce teen pregnancy in communities with the highest rates. Health center data was collected in 2011 for 59 health centers via a Clinical Partner Needs Assessment (CPNA). CPNA data included information describing health center practice setting, number of unduplicated adolescents clients, and utilization of SRH services by adolescent clients, stratified by age, gender, race and ethnicity. Basic descriptive statistics were calculated on the proportion of adolescent male SRH visits, and disaggregated by age, race, and ethnicity. Patterns in utilization of services were compared across age, race, and ethnic categories to identify disparities. All data was analyzed using Stata statistical analytic software. Out of the 59 partner health centers, only 37 (63%) reported valid data. Collectively, these 37 health centers reported serving 27,683 adolescent clients, of which 19,917 (72%) were female and 7,766 (28%) were male. Among all the male client-visits, 19.9% were SRH visits whereas among all the female client-visits, 55.3% were SRH visits. The proportion of adolescent males accessing SRH care services varies considerably across race/ethnic groups. Hispanic males have the lowest proportion of SRH visits compared to the other racial/ethnic groups (6.7%). In contrast, black males have the highest proportion of SRH visits (39.3%). The frequency of visits per client varies substantially among racial/ethnic groups as well. On average, Hispanic male adolescents have the highest frequency of visit per client (2.4) whereas black males have the lowest frequency of visits per client (1.7). Analysis of data point to persistent disparities in access of SRH utilization for adolescent clients, with adolescent males significantly less likely to access SRH services as compared to their female peers. Among adolescent males, black males have the lowest frequency of visits per client. While Hispanic male adolescents visit health centers in a more recurrent manner compared to other racial/ethnic groups, they are less likely to receive SRH services compared to their non-Hispanic peers. Despite efforts to achieve health equity in teen pregnancy prevention efforts, considerable work needs to be done to address disparities in provision of SRH services for male adolescents. Future efforts should focus on addressing barriers to sexual and reproductive healthcare for black and Hispanic adolescent males in particular.