Public Release: 

English-speaking Hispanic youth more likely to have sex early

The JAMA Network Journals

CHICAGO - Hispanic teenagers with lower acculturation (integration into American society) who use Spanish as their primary language are significantly less likely than their English-speaking more highly acculturated Hispanic peers to have had an initial experience of sexual intercourse, according to an article in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Although researchers have begun to estimate the contribution of other social factors such as income or family structure to reported differences among ethnic/racial groups in sexual behavior, sexually transmitted diseases, and pregnancy, a focus on between-group differences within racial/ethnic groups is also necessary to understand these differences in behaviors, according to background information in the article. The current study focuses on the variability within Hispanic adolescents in the onset of sexual intercourse.

Mary B. Adam, M.D., M.A., of the University of Arizona, Tucson, Ariz., and colleagues used preprogram survey data from 7,270 Hispanic or white teens in seventh to 12th grade involved in the Arizona Abstinence-Only Education Program to predict the probability of onset of sexual intercourse based on age, gender, family structure, program location, religiosity, free school lunch, grades, rural residence, acculturation, and ethnicity. Specific attention was given to the influence of their integration into U.S. culture among Hispanic teens. The primary language spoken by the respondents (English, Spanish, or both) was used as a proxy (substitute) measure for their integration into U.S. culture.

"Although Spanish-speaking Hispanic youth differ from English-speaking Hispanic youth on most of the variables in our model...the multivariate analysis allows us to consider the effect of the ethnicity and language beyond the impact of those other predictors," the authors state. "We find that acculturation has a unique contribution to the onset of intercourse beyond those other predictors."

Overall, Hispanic youth were at greater risk for having experienced sexual intercourse than white youth, when controlling for all other predictors, the researchers found. However, when acculturation was considered, less acculturated Hispanic youth were 40 percent less likely to have experienced first intercourse than white youth, 65 percent less likely than English-speaking Hispanic youth and 55 percent less likely than bilingual Hispanic youth. Highly acculturated Hispanic English-speaking teens were 170 percent more likely to have had intercourse than white youth.

"In terms of program development and evaluation, public health professionals should understand that language differences might be indicative of broader cultural differences, even within ethnic groups," the authors conclude. "Today, there is a lack of culturally sensitive sexuality education materials appropriate to the Spanish-speaking adolescents in the southwestern United States. Additional research on Hispanic Spanish speakers with the aim of program development is critical to promote healthy sexual development in this population."

(Arch Pediatr Adolesc Med. 2005; 159:261-265. Available post-embargo at

Editor's Note: This study was supported by grants from the Arizona Department of Health Services, LeCroy & Milligan Associates, Inc., Tucson, to conduct the Arizona Abstinence-Only Education Program and the National Institutes of Health, Bethesda, Md.

Editorial: The Healthy Immigrant Effect

In an editorial accompanying this study, Glenn Flores, M.D., and Jane Brotanek, M.D., M.P.H., of the Medical College of Wisconsin, Milwaukee, state that "This study adds to the already substantial and still growing literature clearly documenting the existence of what has been termed the 'healthy immigrant effect'. ... less acculturation consistently is associated with better health and health outcomes, even though immigrant populations often have a higher prevalence of risk factors associated with worse health outcomes, such as poverty, lack of health insurance, and fewer visits to health care professionals."

"A greater understanding of the healthy immigrant effect has the potential to help to improve the health and health outcomes of all children," the authors write. "Precise identification of the salutary components of traditional Latino culture and unhealthy aspects of U.S. culture could produce fresh approaches and innovations to prevent morbidity and mortality in children from all racial/ethnic and socioeconomic backgrounds. Research documents that less acculturation in Latino children and their parents is associated with lower infant and postneonatal mortality, decreased low birth weight rates, better immunization coverage, a healthier diet, possibly a lower prevalence of asthma and allergies, less sexual activity in adolescents, fewer suicide attempts, and decreased use of tobacco, alcohol, and drugs. This list includes some of the most important public health issues of our time."

"The discovery of a single unifying intervention that could reduce or prevent some or all of these conditions would be hailed as one of the great accomplishments of modern medicine," the authors conclude. "This is the most powerful argument for why we must gain a greater understanding of the influence of acculturation on children's health."

(Arch Pediatr Adolesc Med. 2005; 159:295-297. Available post-embargo at


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