Barriers to sexual and reproductive care among cisgender, heterosexual and LGBTQIA + adolescents in the border region: provider and adolescent perspectives

Abstract

Plain language summary The United States (U.S.) has higher rates of sexually transmitted infections (STIs) and adolescent pregnancy than most other industrialized countries. Furthermore, health disparities persist among racial and ethnic minority adolescents (e.g., African American and Latinx) and in counties located along the U.S.–Mexico border region—they demonstrate the highest rates of STIs and unintended pregnancy among adolescents. A study was conducted as part of formative research for the development of a mobile app that provides gender-inclusive sexual education to adolescents living in the U.S.—Mexico border region. From August 2019 to March 2020, the study team conducted 11 in-depth interviews with healthcare providers and three focus groups with cisgender, heterosexual, and SGM adolescents ages 15–18 (n = 20). Providers and adolescents reported similar difficulties accessing care such as transportation, lack of insurance and cost of services or accessing services without their parent’s knowledge. However, providers shared that some adolescents in this region face extreme poverty, family separation (i.e., parent has been deported), have a mixed family legal status or are binational and have to travel every day from Mexico to the U.S. for school. It is evident that adolescents in the U.S.-Mexico border region face unique challenges that further limit their access to care, making them uniquely vulnerable to STIs and unintended pregnancy. The prototype of the app was developed based on the needs expressed by participants and is being pilot tested. Our findings provide further evidence for the need for service delivery and programs tailored for residents in the border region.

Keywords

• Adolescent health
• Sexual and reproductive health
• LGBTQIA + 
• Access to sexual and reproductive health
• U.S.-Mexico border region