1. “Can you get pregnant when you’re on your period?”
PRL-Institute for Health Policy Studies
Knowledge, Attitudes and Experiences with Contraceptives and Reproductive Health Care
The Teen Voices study was aimed at enhancing our understanding of teens’ attitudes and motivations related to teen pregnancy prevention and use of family planning services.
Negotiating Sex Education Questions & Misinformation
Elodia Villaseñor, MPH
Shelly Kaller, MPH
Dr. Claire Brindis
November 9, 2010

2. Financial Disclaimer No financial conflicts of interest.
The Teen Voices Study was funded by the California Wellness Foundation.

3. California and U.S. Teen Birth Rates 1991- 2008
Source: California Department of Public Health

4. California Teen Birth Rates 2004- 2008
Birth Rate (per 1,000 females age years)
Hispanic
African American
Multiple Ethnicities
American Indian
White
Asian/ PI
Source: California Department of Public Health

5. Outcomes of Teen Births
Poor educational, medical and psychosocial outcomes for mother and child.
Cost to California tax payers $1.7 billion in 2006.
Source: The National Campaign Fact Sheet: Recent Trends in Teen Pregnancy, Sexual Activity and Contraceptive Use. August 2001.
Constantine NA, Nevarez CR, and Jerman P. No Time for Complacency: Teen Births in California. Oakland, CA: Public Health Institute

6. Inclusion Criteria Self- identified Latino/a, African American, White
San Francisco, Los Angeles, Fresno and Alameda Counties
Self- identified Latino/a, African American, White
years old
Not teen parents
The focus is on teens in counties with high teen birth rates
Data (survey & focus groups) gathered from males and females separately
Data (survey & focus groups) gathered from different ethnic groups separately

7. Participants (n=178) Race/ Ethnicity Gender Age Latino/a (83)
African American (52)
White (43)
Gender
Males (72)
Females (106)
Age
years old (average 16.1)

8. Education 95% of participants in school
72% have had a class on preventing teen pregnancy, HIV, or STI’s
21% Middle School only
54% High School only
25% Both Middle School and High School

9. Birth Control or Condom Use
Female vs. Male use of birth control among sexually experienced youth
Females (N=42)
Males (N=27)
Ever Used
Last Used n %
No Method Used 6
14% 11
26% 1 4% 3
11%
Partner used Birth Control, but don't know what type
n/a 5
19% 2 7%
Oral Contraceptive Pill
Depo-Provera Shot 7
17% 4 9% 0%
Patch 2%
NuvaRing
Emergency Contraception 9
21%
Condoms 33
79% 25
58%
93% 20
74%
Withdrawal 16
59%
Oral Sex or Anal Sex

10. Misinformation as a Barrier to Use of Sexual Health Services
Provider Issues: Lack of confidentiality assurances
“ Some teenagers don’t know if they could trust the doctor. Because… their parents pay for their insurance. And if parents are paying for it, doctors will tell everything to them.”
- Latina Female

11. Sexual Health Misinformation
Requirements to access services
Age - 18 years old
Parental permission
Confidentiality
Does it exist?
What diagnoses do they tell your parents?
Clinic vs. Doctor
Expertise?
Confidentiality?

12. Misinformation & Questions: Birth Control Methods
So what happens with the ring? The ring sounds like a funny thing but--it sounds like funky. I'm not gonna lie.
- White male
“I never heard of the patch.”
- White Female
“It doesn’t make sense because, I mean, if you’re going to put a patch right here, how is that going to work for down there?”
-Latina Female

13. Perception of Birth Control: Side Effects
“ Birth control, um, it can mess up your intestines. Like if you don’t research the thing, it’s so many harmful things that can happen afterward. It can cut off your immune system. And instead of helping you, it can make you more, um, open to getting diseases. Like even if you have a little bit [of] bacteria from somebody’s hand, it can just spread into a disease. Like people don’t know that when they take birth control. They’re just saying, ‘Oh, I don't want to get pregnant.’ But they didn't research it. It's actually worse taking birth control than being pregnant. It would be better to get pregnant than to just have birth control because birth control, it doesn't always work and then it's messing up your body.” -African American Female

14. Misinformation: Emergency Contraception
Actually, I had someone come up to me that was like 16 and was like, "Hey, can you get me Plan B?" I was like, "I can't because you have to be 18 to buy it." And they were like, "Yeah, I know. Can you get it for me?" I-I'm not 18, so they were screwed. Uh, but I think they got someone else to buy it for them, but that's inconvenient for them.
-White Male
What are they (males) going to get it for? To kill all their sperms?
- Latina female

15. Sources of (Mis)information
Friends
“You talk to your friends. But you have to be careful who you talk to…”- White female
Parents, Family & Guardians
“My grandmother went over this. She said that a man should always count how many times it takes. For ejaculation, you know- just to be safe.” –African American Male
Sex Education Programs
“That only lasted like 3 minutes (talking about abstinence) and then they jumped to abortion! I was like, ‘psh! Calm down!’... It wasn’t right.” - Latina female .

16. Key Recommendations
Work with parents, schools, and communities to provide better sex education to teens, and improve parent-teen communication.
Set priorities for sexuality education instruction.
Provide youth with tailored education, and “real” adults.
Valuable lessons exist in successful media campaigns, components of which should be replicated in public health media messaging.
Further research is needed regarding teen use of LARCs, EC policy change, contraceptive use and communication within a relationship.

17. .
QUESTIONS? .

18. THANK YOU! Elodia Villaseñor, MPH Elodia.Villaseñor@ucsf.edu
Shelly Kaller, MPH