Date of Award

3-4-2008

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Jessica Illuzzi

Abstract

This study examines how social support is related to reproductive health risk among 15-24 year old immigrant Latinas residing in the San Francisco Bay Area. This is a cross-sectional, clinic-based study, composed of a sample of 68 immigrant Latina women, aged 15-24 (mean 18.7, S.D. 2.2), recruited from waiting rooms at two clinics in Oakland. Participants completed an interviewer-administered questionnaire and provided blood and self-obtained vaginal swab specimens to test for sexually transmitted infections. Three dimensions of social support were assessed: 1) functional support, using the Medical Outcomes Study (MOS) Social Support Survey; 2) structural support (quantity of support sources); and 3) social network characteristics. Primary reproductive health outcomes assessed included: 1) high risk sexual behaviors; 2) history of teen pregnancy and/or abortion; and 3) prevalence of Herpes Simplex Virus 2 (HSV-2), Chlamydia trachomatis, and Trichomonas vaginalis. Analyses examined relationships between social support measures and reproductive health behaviors and outcomes using multivariate logistic regression, adjusting for age, religiosity, length of stay in the U.S., and socioeconomic and marital status. 95.6% of participants were sexually active, with the mean age of sexual initiation being 15.6 years (S.D. 1.7). 30.8% had more than one sexual partner over the past year, 44.6% reported a teen pregnancy, and 12.3% had an abortion. Overall STI prevalence was 13.3%. Compared to those with lower support measures, participants with higher functional tangible support scores, as well as those who identified more people available for affectionate support and positive social interactions (structural support measures), were significantly more likely to have used condoms in the past year (adjusted odds ratios [A.O.R.s]: 2.31, 4.59, and 4.0, respectively, p<0.05). Several measures of structural social support were protective against teen pregnancy: participants who identified more people they could count on for informational, affectionate support and positive social interactions, were less likely to have had a teen pregnancy (A.O.R.s: 0.27, 0.36, and 0.32, respectively, p<0.05,). Overall functional social support was protective against abortion (A.O.R. 0.16, p<0.05). No significant associations were found between measures of social support and STI prevalence; however, a trend was noted whereby participants with higher measures of perceived functional support were more likely to have an STI. Social network characteristics found to be related to outcomes included gender proportions of the network and presence or absence of U.S.-born people in the network. Several different dimensions of social support are associated with decreased risk of specific reproductive health behaviors and outcomes among young Latina immigrants. Use of a multi-dimensional social support instrument provides for richer analyses of these relationships, generating information that could be utilized for targeting support interventions and risk prevention in this population.

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