As Hispanics make up an increasing share of the U.S. population, there is a growing awareness that cultural, economic and social factors influence the need for and use of sexual and reproductive health services among this group. In 2000, the incidence of AIDS among Hispanics was almost four times the incidence among non-Hispanic whites, and Hispanic teens are much more likely than white teens to become pregnant. The July/August 2004 issue of Perspectives on Sexual and Reproductive Health offers research that identifies gaps--particularly in cultural sensitivity in prevention programming and service provision--and makes recommendations for addressing the diverse needs of Hispanic teenagers and adults.

Despite the higher risk of pregnancy among Hispanic teens, few pregnancy prevention programs have been developed specifically for Hispanic youth, according to "Practitioners' Perspectives on Effective Practices for Hispanic Teenage Pregnancy Prevention," by Stephen T. Russell of the University of California, Davis, et al. Practitioners interviewed by the authors emphasized the challenge of balancing the predominant values guiding U.S. teenage pregnancy prevention programs (self-sufficiency and individual achievement) with Hispanic cultural traditions that place the highest value on family and parenthood roles, especially for women. To effectively serve Hispanic teenagers, the authors suggest, practitioners must not only speak Spanish, but also understand youth culture, gender roles and family relationships within these communities.

An important component of teenage pregnancy prevention programs is the provision of contraceptive services. In "A Comparison of Hispanic and White Adolescent Females’ Use of Family Planning Services in California," M. Rosa Solorio et al. of the University of California, Los Angeles, find that although Hispanic and white adolescents are almost equally likely to use family planning services, Hispanic teens are much more likely to have already been pregnant before using such services. The authors recommend sending Hispanic adolescents a clear message that contraceptive services are available and should be used before a woman ever becomes pregnant.

Sexual and reproductive health efforts designed specifically to meet the needs of adults in Hispanic communities are also rare, according to "A Randomized Study of a Pregnancy and Disease Prevention Intervention for Hispanic Couples," by S. Marie Harvey of the University of Oregon et al. The authors examined risk-related behavior among a sample of 146 Hispanic couples participating in two interventions in East Los Angeles, one a three-session risk-reduction program designed to address the specific needs and characteristics of the Hispanic community, and the other a one-session pregnancy and sexually transmitted disease prevention program. At a three-month follow-up, both groups reported a reduced frequency of unprotected sex and increased use of effective contraceptive methods and of condoms. However, outcomes did not differ between groups, suggesting that bringing couples together for sexual and reproductive health education may be sufficient to encourage communication, joint decision-making and behavior change.

Migrant workers are a subset of U.S. Hispanics who face particular sexual health risks, according to "Use of Commercial Sex Workers Among Hispanic Migrants in North Carolina: Implications for the Spread of HIV," by Emilio A. Parrado of Duke University et al. More than a quarter of 442 Hispanic migrants surveyed in Durham, NC, reported using the services of a commercial sex worker during the previous year. Nearly all (93%) respondents reported they always used condoms with commercial sex workers; however, the proportion of men who reported that they would always use a condom dropped significantly if they knew the sex worker well. To limit HIV risk associated with use of commercial sex workers--both among migrants themselves and among partners in their home communities--the authors recommend targeting public information campaigns on condom use and the risks of commercial sex worker use to recent immigrants, especially single men.