Abstract
Latino youth in the United States are at higher risk for negative sexual outcomes compared to their European American counterparts. Adherence to traditional sexual values may protect against or increase their risk. Past studies have generally utilized proxy measures, such as acculturation, to assess sexual values. The objective of the current study was to develop and test culturally based sexual values measures among Latino youth. Focus groups and qualitative interviews were conducted to generate themes related to sexual values. Six measures were developed: three related to gender role norms (Sexual Talk as Disrespectful, Satisfaction of Sexual Needs as Important, Female Virginity as Important) and three related to comfort regarding sexuality (Comfort with Sexual Communication, Sexual Comfort, and Sexual Self-Acceptance). The scales’ psychometric properties were assessed in a sample of 694 sexually active young Latinos. Results indicate that these measures conformed to single-factor scales and displayed acceptable reliabilities. Correlations with conceptually related measures were in hypothesized directions. Findings suggest it is feasible to directly assess sexual values in a valid and reliable manner. The measures presented in the current article represent tools for such assessment.
Keywords: sexuality, values, adolescence, Latino, measurement
Latino youth in the United States are at higher risk for negative outcomes associated with sexual activity, including sexually transmitted infections (STIs) and early pregnancy compared to their European American counterparts (Centers for Disease Control and Prevention [CDC], 1999; Guttmacher Institute, 2006). Latinos in general are disproportionately affected by HIV, accounting for approximately 18% of all AIDS cases in the United States while comprising only 14% of the population (CDC, 2001). In 2004, Latinos represented one quarter of new AIDS cases among 13–18 year olds (Kaiser Family Foundation, 2006). Moreover, Latina women are 2.8 times more likely than European Americans to give birth between 15 and 19 years of age and are less likely to use contraception than European Americans or African Americans (Stone, 2006). Between 1995 and 2002, contraceptive use increased among European American youth but declined among Latino adolescents (Stone, 2006), putting Latinos at even greater risk for unintended pregnancy and STIs/HIV. These data raise significant public health concerns, given that Latinos are the fastest growing ethnic minority group in the United States; by the year 2050, they are expected to constitute approximately 25% of the population (U.S. Census Bureau, 2002).
To better understand sexual outcomes among Latino youth, it is essential to understand cultural norms and values (Betancourt & Lopez, 1993; Phinney & Flores, 2002) that underlie sexual behavior. Important differences in sexual values may operate across cultural subgroups of adolescents and contribute to ethnic differences in sexual activity and related outcomes (Furstenberg, Morgan, Moore, & Peterson, 1987; Upchurch, Levy-Storm, Sucoff, & Aneshensel, 1998). Although researchers have stressed the importance of examining values to predict sexual behavior among Latinos, few sexual values measures have been developed for use with Latinos (see B. V. Marin, Gomez, Tschann, & Gregorich, 1997; Villarruel, Jemmott, Jemmott, & Ronis, 2004, for exceptions). Of the few extant measures, most have been used with Latino adults but not youth. The current study seeks to fill this gap in the scientific literature by utilizing a culturally based approach to develop and test sexual values measures for young Latino men and women.
Proxy Measures for Sexual Values
Acculturation
Studies of sexual behavior among Latino youth have typically used proxy measures to assess sexual values. A common proxy measure is acculturation, based on the assumption that low levels of acculturation are likely to be associated with more traditional sexual values. Research suggests that acculturation and related constructs, language use or country of nativity, are associated with sexual activity among young Latinos. For instance, low acculturation predicts low sexual activity at young ages (Ford & Norris, 1993) and delayed initiation of first sexual intercourse (Reynoso, Felice, & Shragg, 1993). Latina adolescents delay first intercourse if they and their parents are foreign born (Upchurch, Aneshensel, Mudgal, & McNeely, 2001). Moreover, when both adolescents and their mothers are highly acculturated, adolescents are more sexually experienced as compared to youth in families where the mother reports low acculturation (Pasch et al., 2006). Thus, previous research suggests that low acculturation predicts delayed initiation of intercourse among young Latino men and women.
Recent research, however, indicates that the relationship between acculturation and sexual behavior may be more complex than previously suggested. Among new immigrants, adolescents living in English-speaking homes are at less risk for sexual activity than their counterparts in Spanish-speaking homes; the opposite is true among U.S.-born Latino youth, who are at higher risk if they are living in English-speaking homes (Guilamo-Ramos, Jaccard, Pena, & Goldberg, 2005). In the absence of measures that specifically assess sexual values, it is difficult to explain these more complex associations between acculturation and sexual outcomes.
A further complexity is that acculturation appears alternately protective or risk enhancing, depending on the sexual outcome studied. Although low acculturation protects against early sexual initiation, once sexual activity has been initiated, low acculturation puts Latinos at risk for reduced condom use (Ford & Norris, 1993; B. V. Marin, Tschann, Gomez, & Kegeles, 1993; B. V. Marin et al., 1997). Latina immigrants are at greater risk for unplanned pregnancy than U.S.-born Latinas, which in part may be explained by lower rates of condom use among immigrants (Brindis, Wolfe, McCarter, Ball, & Starbuck-Morales, 1995). Moreover, Spanish-speaking Latinos have less positive attitudes about condom use and believe that they cannot do anything to avoid AIDS as compared to European Americans (B. V. Marin et al., 1993). Among women, less acculturated Latinas are less likely to carry and use condoms (B. V. Marin et al., 1993; G. Marin & Marin, 1991). Among Latino men, although acculturation does not appear to be related to condom use, those who subscribe to traditional gender role norms exhibit lower condom use efficacy and, in turn, lower condom use than those who do not endorse traditional gender role norms (B. V. Marin et al., 1997).
Studies using acculturation measures have drawn attention to the importance of cultural influences to sexual activity, but they provide little insight into what substantively comprises sexual values for young Latino men and women and, in turn, which values or norms may be protective or risk enhancing in terms of sexual debut and condom use (Flores, Eyre, & Millstein, 1998). A better understanding of the sexual values relevant to youth would enhance our capability to assess specific risk and protective factors that may be associated with sexual behavior.
Gender Role Norms
In addition to acculturation, a common proxy measure for sexual values is gender role norms (B. V. Marin, 2003; Phinney & Flores, 2002). Past studies with adult Latinos suggest that gender role norms, including marianismo (i.e., women as chaste, virtuous, and submissive to men) and machismo (i.e., men as strong, independent, and in a position of authority), influence expression of sexuality and sexual behaviors (see B. V. Marin, 2003; Pavich, 1986; Phinney & Flores, 2002). Qualitative research with young Latinos confirms that these gender stereotypes operate among youth as well (Marston, 2004). These norms imply that women are expected to maintain their virginity until marriage (B. V. Marin et al., 1997; Padilla & Baird, 1991) and men have low sexual impulse control (Villarruel, 1998). Related studies with Latino youth indicate that maternal premarital virginity (Hovell et al., 1994) and adolescents’ attitudes toward premarital sex (Christopher, Johnson, & Roosa, 1993) are associated with sexual involvement. The results of these studies suggest that assessing aspects of gender role norms that focus specifically on sexual values may promote a better understanding of sexual behavior among Latino youth.
Specific Sexual Values
Research with Latino adults provides insight into specific sexual values that may be extended to studies of youth, including sexual communication and sexual comfort (B. V. Marin, 2003; B. V. Marin et al., 1997). For Latino adults, particularly women, communicating about sex appears to cause discomfort and is perceived as inappropriate (B. V. Marin, 2003); in turn, Latino men are expected to respect women by not discussing sex (B. V. Marin et al., 1997). Ethnographic research with youth confirms these findings (Marston, 2004). Such lack of communication about sexual issues has the potential to lead to negative outcomes, including coercive sexual intercourse, early sexual initiation, and low rates of condom use. Sexual comfort, or a general level of comfort and positive emotional orientation toward sexuality (Fisher, 1990), appears to foster sexual communication and condom use self-efficacy, which in turn predicts greater condom use (B. V. Marin et al., 1993, 1997). The notion of sexual comfort, however, is inconsistent with traditional gender role norms suggesting that women should be sexually naïve, and both adult Latino men and women report high levels of sexual discomfort (B. V. Marin, 2003; B. V. Marin et al., 1997). In light of the adult literature, sexual communication and sexual comfort may be important sexual values to consider among Latino youth.
Finally, sexual self-acceptance has been identified as an important sexual value for youth. Sexual self-acceptance, or sexual self-concept, is an evaluation of one’s sexuality that may develop and increase with age and maturity (Winter, 1988). Among ethnically diverse youth, sexual self-acceptance is positively associated with contraceptive use (Tschann & Adler, 1997; Winter, 1988). Thus, sexual self-acceptance may be essential to consider among Latino youth.
Current Study
The current study aimed to address gaps in the extant literature by using a combination of qualitative and quantitative strategies to develop sexual values measures for use with Latino youth. Measurement development was approached from a culturally based perspective. Although researchers underscore the importance of culturally based methodological approaches to the development and validation of assessment tools, such methods are rarely utilized (Hitchcock et al., 2005; Rogler, 1999; Roosa, Dumka, Gonzales, & Knight, 2002). In the developmental phase of the study, measures were created from themes generated in focus groups and open-ended interviews. In the quantitative phase, the sexual values measures were administered using a quantitative survey, and analyses were conducted to assess factor structure, internal consistency, and construct validity.
Conceptually Related Measures
To assess the construct validity of the sexual values measures developed in the current study, we examined their relations to conceptually related measures: participant age, sexual experience (number of partners over the lifetime and in the past year), and acculturation (Spanish language use, English language use). Based on the literature, we hypothesized that greater acculturation would relate to less traditional sexual values and higher level of comfort with sexuality. We also expected that older adolescents would exhibit more sexual self-acceptance and sexual comfort than younger adolescents, given that sexual self-concept has been shown to increase with age (Winter, 1988). We included sexual experience to explore whether number of sexual partners might relate to less traditional sexual values and greater comfort with sexuality.
Method
Developmental Phase
Focus groups
Fifty-five sexually active Latino youth, ages 16–22 years, participated in six focus groups. The purpose was to obtain information about values and beliefs related to sexuality among Latino youth living in the United States. Focus group participants were recruited by flyers distributed at community youth organizations. Interested youth called the research offices and were screened for eligibility. Focus groups were divided evenly by gender (three male and three female groups) and led by bilingual young adults, who were matched by gender to the groups. Approximately 8 to 10 individuals attended each group. Two groups were led primarily in Spanish, two in English, and two in both languages. Focus groups were conducted according to guidelines suggested by Morgan (1997). The protocol consisted of a series of open-ended questions intended to promote discussion about sexual values, including gender roles, sexual communication, and sexual comfort, followed by probes. Focus group leaders allowed conversations to evolve naturally among group members to promote the emergence of novel and potentially important concepts. Focus groups were audiotaped and transcribed by bilingual research assistants.
Individual interviews
After the focus groups, 24 individual qualitative interviews were conducted with another set of youth, who were recruited from the same population using similar methods. Interviewers were matched by gender to participants. Individual interviews allowed participants to disclose more personal information about themselves and their sexual values and experiences than they might reveal in a focus group environment. Questions similar to those used in the focus groups were asked. Interviews were audiotaped and transcribed.
Establishing themes
From focus group and interview transcriptions, bilingual research assistants and investigators created a list of items using participants’ wording or items that captured themes. For example, when discussing ways in which Latino girls and boys are supposed to act with each other, one young woman said, “Se tiene que ir al altar siendo virgen [you have to go to the altar a virgin]”; similarly, in another group, a participant said, “Hasta que te cases tienes que ser virgen [you have to be a virgin until you get married].” These statements led to the item, “Do you think that girls should be virgins when they get married?”
When discussing issues that are difficult to talk about in sexual situations, a participant said, “The things… that you just don’t mention at all, oral sex, stuff like that, that’s the thing that is hard to talk about.” Another said, “If you get pregnant, are you going to have an abortion…are you going to keep it?” These led to the items: “How would you feel talking about oral sex (going down)?” and “How would you feel talking about what you would do about a pregnancy?”
The notion of sexual talk as disrespectful in a romantic relationship emerged in focus group discussions. One young man said, “Si yo la quiero, no puedo hablar de sexo con ella, porque se que quiero respetarla… o sea antes de eso conocerse mejor y hablar sobre el sexo, pero después [If I love her, I can’t talk about sex with her, because I want to be respectful of her… you have to get to know each other better, and talk about sex later].”
Through focus groups and interviews, we found that reports of sexual desire, which we initially expected would be limited to men, were applicable to young women as well. Therefore, in addition to items focusing on male desire, we included items that asked about female desire.
Items also were included from two extant scales—the 7-item Sexual Comfort Scale (B. V. Marin et al., 1997) and 10-item Sexual Self-Concept Scale (Winter, 1988)—that are associated with contraception use in adult Latino and multiethnic samples (B. V. Marin et al., 1997; Tschann & Adler, 1997). Using these items and the items developed from focus groups and interviews, we compiled a list of 124 total items. Items were then grouped into scales, based on similarity of themes, with approximately 8 to 24 items per scale. Five scales—Sexual Desire as Uncontrollable, Female Virginity as Important, Comfort with Sexual Communication, Sexual Comfort, and Sexual Self-Acceptance—were consistent with the existing literature. An additional theme emerged that addressed the notion of the timing of discussion about sex within a relationship and issues of respect. Researchers have suggested that in Latino culture sexual talk may be considered disrespectful, particularly in the earlier stages of a relationship (B. V. Marin, 2003; Tschann & Adler, 1997). We labeled this scale Sexual Talk as Disrespectful.
Translation
Items were translated into Spanish or English as necessary. Spanish and English translations were reviewed side by side in a group comprised of bilingual research assistants and investigators. Translations were compared for literal meaning, appropriateness, and shared conceptual meaning. A decentering process (G. Marin & Marin, 1991; Villarruel et al., 2004) was used in which both languages were considered equally important. With the goal of retaining the original wording, item translations were discussed and then adapted as necessary until group consensus regarding functional equivalence was attained. In a limited number of cases, where consensus was not possible, items were dropped.
Field pretest
Following the translation process, 42 cognitive interviews in Spanish and English were conducted. In the cognitive interviews, interviewers read each item in the quantitative interview aloud and solicited participants’ feedback regarding meaning, appropriateness, utility of response choices, and comfort level (Alaimo, Olson, & Frongillo, 1999; Carbone, Campbell, & Honess-Morreale, 2002). The research team met regularly to discuss participants’ responses. Problematic items were discussed and either modified or dropped. The revised interview was then utilized in subsequent cognitive interviews, and this iterative process of revision continued until all problematic wording was resolved.
Quantitative Phase
Sample
After measure development, the quantitative phase of the research was initiated. The research reported here was part of a larger study of relative power, condom use influence strategies, and condom use among Latino youth of Mexican, Salvadoran, and Nicaraguan origin (Tschann, Flores, & de Groat, 2007). These three ethnic groups comprise the largest Latino subgroups in San Francisco and were therefore the focus of the parent study. We recruited 694 sexually active Latinos (61% women) ages 16–22 years (M = 18.47, SD = 1.65) from a large HMO and from community clinics. All participants were in heterosexual relationships. Over half (55%) of the participants identified as Mexican American, 16% as Salvadoran American, 9% as Nicaraguan American, and 20% as some combination of these three ethnicities. Seventy-six percent of the participants, and 22% of their mothers, were U.S. born. On average, participants’ mothers and fathers completed 10.66 (SD = 3.76) and 10.36 (SD = 4.0) years of education, respectively. Fifty-seven percent of the participants’ parents were married or living together, and 38% were divorced or separated; five percent of youth had only one or no living parents. The vast majority of participants (93%) chose to complete the questionnaire in English; the remainder completed it in Spanish.
Procedure
Institutional Review Board approval was obtained from the university and the HMO. Trained interviewers obtained informed consent from participants and a parent if the adolescent was under 18 years of age and not seeking confidential health services. Individual interviews were conducted at HMO or community clinics. Interviews were 1 hr in duration and were conducted by bilingual young adults, who were matched by gender to participants. Half of the scales were self-administered; for the remainder of the scales, interviewers read questions aloud. Responses were recorded in laptop computers. Participants received $50 compensation.
Measures
Six sexual values measures were assessed: Sexual Talk as Disrespectful (5 items), Sexual Desire as Uncontrollable (10 items), Female Virginity as Important (10 items), Comfort with Sexual Communication (10 items), Sexual Comfort (10 items), and Sexual Self-Acceptance (10 items). As outlined in our Results section, Sexual Desire as Uncontrollable diverged from our initial conceptualization. Instead, a subset of items emerged as a factor, which we labeled Sexual Satisfaction as Important. Final scales are presented in Table 1.
Table 1.
|
Note. Superscript R indicates that items are reverse coded.
Items 1–5 are from the Sexual Comfort Scale (B. V. Marin et al., 1997).
Items 1 and 2 are adapted from the Sexual Self-Concept Scale (Winter, 1998).
In Table 1, reverse-coded items are indicated with a superscript R. Response choices were based on 4-point Likert scales for Satisfaction of Sexual Needs as Important and Female Virginity as Important (1 = definitely no to 4 = definitely yes) and for Comfort with Sexual Communication and Sexual Comfort (1 = very uncomfortable to 4 = very comfortable) and a 5-point Likert scale for Sexual Self-Acceptance (1 = not at all to 5 = very much). Response options for Sexual Talk as Disrespectful were calculated based on yes/no responses for subitems a–f, which were assigned a score of 1 or 0, respectively. Subitem scores were then summed to obtain item scores, ranging from 0 (always okay) to 6 (never okay). Of note, the majority of individuals scored either 0 or 1 for these items, thus the range for the scale was restricted and the mean low.
Age and acculturation (English language use, Spanish language use) were included to assess the construct validity of our scales. Acculturation was assessed using the language use subscale from the Bidimensional Acculturation Scale (G. Marin & Gamba, 1996), which shows high internal consistency and validity with Mexican and Central Americans (G. Marin & Gamba, 1996). Coefficient alphas were .89 for English and .89 for Spanish language use. Number of sexual partners (over the lifetime and in the past year) was included for exploratory purposes.
Statistical analyses
Sexual values scales were examined in the total sample by including all items in an exploratory factor analysis (EFA) using oblique rotation. A six-factor solution was specified. This analysis was repeated for each gender. Internal consistency using Cronbach’s alpha was assessed for each scale. Intercorrelations between the sexual values measures were conducted, and t tests were performed to examine gender differences. Construct validity was assessed using correlations between the sexual values scales and conceptually related measures. Partial correlations, adjusting for participant age, were conducted for number of sexual partners in a lifetime. For all correlations, Fisher’s transformations to z values were conducted, and correlations were compared across genders to assess for statistically significant differences.
Results
EFAs
EFAs were conducted for the total sample and separately within genders. Scales were developed based on factor eigenvalues 1.0 and item loadings of 0.45. Five factors aligned with our proposed scales: Sexual Talk as Disrespectful, Female Virginity as Important, Comfort with Sexual Communication, Sexual Comfort, and Sexual Self-Acceptance. Sexual Desire as Uncontrollable did not emerge as a factor in the total sample or within genders. Instead, a 4-item subset emerged as a factor, conceptually representing Satisfaction of Sexual Needs as Important.
Of note, two of the proposed gender role norms scales held for one gender but not the other. First, Female Virginity as Important held up only for young men but not young women. Second, Sexual Talk as Disrespectful held up for young women but not young men.
Internal Consistency
Table 1 displays the final six scales and their reliabilities. The total number of respondents varied slightly for these analyses (n = 684 to 694) due to missing data for some items. Coefficient alphas ranged from .61 to .89. Scales were created by summing the items and dividing by the total number of items per scale.
Gender Differences
Table 2 shows descriptive statistics. T tests by gender were conducted for the scales. Men reported higher scores than women for Satisfaction of Sexual Needs as Important, t(691) = 11.45, p < .001; Female Virginity as Important, t(692) = −4.60, p < .001; Sexual Comfort, t(691) = 7.74, p < .001; and Sexual Self-Acceptance, t(692) = 5.45, p < .001. In light of these differences, intercorrelations between the scales and correlations with theoretically related variables are presented separately by gender in Tables 3 and 4. In addition, all intercorrelations and correlations that are significantly different across gender are indicated in Tables 3 and 4.
Table 2.
Total sample (n = 694) M (SD) or % |
Women (n = 426) M (SD) or % |
Men (n = 268) M (SD) or % |
|
---|---|---|---|
1. Sexual talk as disrespectful | 0.48 (0.72) | 0.49 (0.70) | 0.46 (0.75) |
2. Satisfaction of sexual needs as important | 1.92 (0.65) | 1.72 (0.58) | 2.25 (0.62) |
3. Female virginity as important | 2.33 (0.67) | 2.42 (0.69) | 2.19 (0.62) |
4. Comfort with sexual communication | 3.38 (0.47) | 3.36 (0.47) | 3.40 (0.49) |
5. Sexual comfort | 3.10 (0.56) | 2.98 (0.55) | 3.30 (0.53) |
6. Sexual self-acceptance | 4.38 (0.67) | 4.27 (0.70) | 4.55 (0.59) |
7. Age | 18.47 (1.65) | 18.35 (1.73) | 18.67 (1.50) |
8. Sexual partners (lifetime) | |||
1 | 29% | 39% | 14% |
2–4 | 40% | 41% | 39% |
5–10 | 23% | 14% | 36% |
10 | 8% | 6% | 11% |
9. Sexual partners (past year) | |||
1 | 62% | 68% | 55% |
2 | 21% | 18% | 27% |
3 | 8% | 8% | |
4–5 | 6% | 4% | 6% |
>5 | 3% | 2% | |
10. English Language use | 3.81 (0.86) | 3.87 (0.83) | 3.73 (0.89) |
11. Spanish Language use | 2.82 (0.97) | 2.89 (1.05) | 2.72 (0.85) |
Table 3.
Measure | 1 | 2 | 3 | 4 | 5 | 6 |
---|---|---|---|---|---|---|
1. Sexual Talk as Disrespectful | − | .17*** | .42***a | −.25***a | −.18*** | −.09a |
2. Satisfaction of Sexual Needs as Important | .18** | − | .28***a | −.08a | −.09a | −.07 |
3. Female Virginity as Important | .28*** | .07 | − | −.19*** | −.19*** | −.33*** |
4. Comfort with Sexual Communication | .03 | .10 | −.06 | − | .61***a | .32***a |
5. Sexual Comfort | −.10 | .16** | −.14* | .34*** | − | .38***a |
6. Sexual Self-Acceptance | −.33*** | −.14* | −.23*** | .00 | .12 | − |
Note. Women appear above the diagonal and men appear below the diagonal.
Correlations are significantly different for women versus men (p < .05).
p < .05.
p < .01.
p < .001.
Table 4.
Sexual values measures | Age | No. of sexual Partners (lifetime)a |
No. of sexual partners (past year) |
English language use |
Spanish language use |
---|---|---|---|---|---|
Sexual Talk as Disrespectful | −.05 | −.08 | −.11* | −.26*** | .22*** |
.01 | −.04 | −.16** | −.32*** | .26*** | |
Satisfaction of Sexual Needs as Important | −.07 | .01 | .02 | −.22*** | .34*** |
−.04 | .13* | .14* | −.29*** | .23** | |
Female Virginity as Important | −.10* | −.20** | −.27*** | −.18*** | .37*** |
−.05 | −.14* | −.14* | −.28*** | .25*** | |
Comfort with Sexual Communication | .08 | .03 | −.01 | .07a | −.06 |
.09 | −.03 | .02 | −.09 | .03 | |
Sexual Comfort | .15** | .04 | −.01 | .01 | −.05 |
.18** | .02 | .01 | −.07 | .07 | |
Sexual Self-Acceptance | .17**b | .02 | .07 | −.04b | −.06b |
−.01 | .02 | .04 | .20** | −.22** |
Note. Correlations for women appear above and men appear below.
Controlling for age.
Correlations are significantly different for women versus men (p < .05).
p < .05.
p < .01.
p < .001.
Intercorrelations Between Sexual Values
Intercorrelations between the sexual values scales are presented by gender in Table 3. Many of the measures correlated in the expected directions. The sexual values scales that reflect gender role norms (Sexual Talk as Disrespectful, Satisfaction of Sexual Needs as Important, and Female Virginity as Important) were significantly interrelated, with one exception. Satisfaction of Sexual Needs as Important was not related to Female Virginity as Important for young men.
Two of the three sexual values scales that reflect comfort regarding sexuality, Comfort with Sexual Communication and Sexual Comfort, were significantly interrelated. Sexual Self-Acceptance, however, was related to Comfort with Sexual Communication and Sexual Comfort for young women but not young men.
As expected, for young women, the values reflecting comfort with sexuality (Comfort with Sexual Communication, Sexual Comfort, and Sexual Self-Acceptance) were for the most part negatively related to the values reflecting gender role norms (Sexual Talk as Disrespectful, Satisfaction of Sexual Needs, and Female Virginity as Important). However, for young men, only Sexual Self-Acceptance, and to some extent Sexual Comfort, exhibited negative relations with the scales reflecting gender role norms. In contrast to women, young men who reported higher levels of Sexual Comfort also endorsed Satisfaction of Sexual Needs as Important.
Correlations With Conceptually Related Measures
Age
As illustrated in Table 4, older youth exhibited more Sexual Comfort compared to younger adolescents. For women, but not men, older youth exhibited more Sexual Self-Acceptance compared to their younger counterparts.
Sexual experience
As expected, participants with more sexual experience, as measured by the number of sexual partners reported over a lifetime and within the past year, were less likely to endorse Female Virginity as Important. Satisfaction of Sexual Needs as Important increased with number of sexual partners, particularly among men. Sexual experience was not related to Sexual Communication, Sexual Comfort, or Sexual Self-Acceptance.
Acculturation
All three measures relating to gender role norms, Sexual Talk as Disrespectful, Satisfaction of Sexual Needs as Important, and Female Virginity as Important, were correlated in the expected direction with the acculturation variables, such that more acculturated youth (those with more English language use and/or less Spanish use) were less likely to endorse these sexual values compared to less acculturated youth. Although the acculturation measures were not related to Sexual Comfort or Comfort with Sexual Communication, acculturation was related to Sexual Self-Acceptance for young men. More acculturated men reported higher Sexual Self-Acceptance compared to less acculturated men.
Discussion
The current study utilized focus groups and qualitative interviews to develop culturally based sexual values measures for Latino youth. Few studies have utilized sexual values measures with Latino populations, and, of those, most extant measures have targeted adults. Our findings confirm the feasibility of using a culturally based approach to measure development and provide researchers with appropriate tools to assess sexual values among young Latino men and women. This process is time consuming but offers a more targeted assessment of sexual values for young Latinos than has previously been reported in the literature.
Culturally Salient Sexual Values
We developed six sexual values measures that are consistent with existing theoretical and empirical literature, which focuses primarily on Latino adults. Moreover, the young men and women who participated in the developmental phase of this study offered new insight into how youth view their sexual relationships. For instance, the notion of sexual talk as disrespectful emerged as a new and measurable concept, which differed substantially from the notion of comfort with sexual communication. Moreover, two constructs that could be expected to overlap conceptually, Sexual Comfort and Sexual Self-Acceptance, emerged as separate factors and operated differently in terms of their associations with conceptually related measures. For instance, Sexual Comfort increased with age but was not related to any other study variable for either gender; in contrast, Sexual Self-Acceptance increased with age only for young women but was related to acculturation among young men.
The sexual values scales that reflect gender role norms, Sexual Talk as Disrespectful, Satisfaction of Sexual Needs as Important, and Female Virginity as Important, were associated with acculturation. More acculturated youth were less likely to endorse these sexual values. Our results highlight that female virginity appears to lose importance as sexually active youth become more acculturated. This may be an important point to consider when determining whether to focus prevention efforts on promotion of abstinence or safer sexual behaviors. If virginity is not highly valued among acculturated young Latinos, then promoting safer sexual practices among this group may be a more effective intervention strategy than encouraging abstinence for the prevention of unwanted pregnancy and STIs.
It is important to emphasize that two of the proposed gender role norms exhibited differential fit across the genders. Female Virginity as Important emerged as a factor for young men but not young women, whereas Sexual Talk as Disrespectful emerged as a factor for young women but not young men. These results are not surprising given that gender role norms are likely to be interpreted somewhat differently by young men and women. Consistent with past ethnographic research with Mexican youth (Marston, 2004), most of the young women in our focus groups and interviews reported that they did not view premarital virginity as particularly important, yet they acknowledged the existence of stereotypes around virginity and revealed concern about young men’s preoccupation with the importance of female virginity. Ethnographic research also suggests that young Latino men have an extremely difficult time introducing sexual talk in relationships with female partners, perhaps because sexual communication is “gendered” and therefore is only sanctioned among men (Marston, 2004). This research further indicates that men believe women are unwilling to engage in any conversation about sexual topics.
Two sexual values reflecting comfort with sexuality, Sexual Comfort and Sexual Self-Acceptance, increased with age for young women but were not related to level of sexual experience. As such, a young adolescent woman could potentially have numerous sexual partners yet lack sexual comfort and self-acceptance. Perhaps as a function of maturity, older female adolescents are more comfortable with their sexuality and display more sexual self-acceptance. These findings are particularly interesting given past research that suggests that sexual self-acceptance is a developmental construct (Winter, 1988). Our findings indicate that sexual comfort is also developmentally based for young women and men. An important gender discrepancy was evidenced, however. For young Latino men, but not women, it appears that acculturation rather than age may play a larger role in the development of sexual self-acceptance.
The current study raised another interesting gender consideration. The concept of sexual desire as uncontrollable did not fit well in our sample. Although we examined this scale in several ways, in the total sample and within genders we consistently found that a subset of our original items emerged as a factor for both genders, which we labeled Satisfaction of Sexual Needs as Important. This scale operated differently for young men and women. Young men who endorsed this scale did not report that female virginity was important. For men, it may be difficult to endorse the importance of having one’s sexual needs met (or a female partner’s needs met) and concurrently uphold that virginity should be maintained given the contrary nature of these beliefs. This was not the case for young women, however, who endorsed both notions simultaneously. In addition, young men who viewed satisfaction of sexual needs as important also reported higher sexual comfort but lower sexual self-acceptance. This finding suggests that perhaps young men may feel some guilt about wanting their sexual needs met.
A final gender inconsistency is noteworthy. For young women, but not men, those who were less comfortable with sexual communication also endorsed sexual values reflecting traditional gender role norms. These women considered sexual talk to be disrespectful and virginity to be important. Our findings suggest that young Latino women may be comfortable communicating about sex only when they have relinquished these traditional gender role norms. This does not appear to be the case for men, who are able to retain these norms and simultaneously exhibit comfort with sexual communication. In part, this difference may result from the traditional male role of initiator in sexual relationships, which may necessitate a degree of openness around sexual communication. Our findings regarding sexual communication raise questions about how to shape interventions to promote healthier sexual behaviors among young Latino women. The Hispanic/Latino Adaptation Task Force, which modified the original 1991 National Guidelines for Sexuality Education for Hispanic communities (National Guidelines Task Force, 1995), identified communication as one of the key interpersonal skills for sexual health. Among young Latino women who adhere to more traditional sexual values, it seems particularly important to consider ways to incorporate strategies to improve sexual communication and foster healthier sexual behaviors while simultaneously respecting traditional values and beliefs. As suggested by Marston (2004), the first step to improving sexual communication among heterosexual youth may be to avoid language that reinforces traditional gender stereotypes and thereby encourage gender-neutral communication.
Culturally Based Methodological Approach
The process of using both qualitative and quantitative strategies was invaluable in terms of understanding the target population in this study and developing relevant assessment tools. For investigators who wish to incorporate similar methods, we recommend allowing ample time for culturally based methodological research. It is critical to use bilingual, gender- and age-appropriate interviewers to conduct focus groups and interviews. We also recommend an iterative process of questionnaire development, in which quantitative interviews are continuously revised until problematic issues are resolved. We believe that researchers who incorporate these methods of measurement development, regardless of the study population, will increase the likelihood that the study measures are valid in the population being studied.
Limitations
Gender was particularly important to consider when constructing sexual values measures. Consequently, we lacked statistical power to examine the psychometric properties of the measures within each ethnic subgroup in addition to gender. Future research with larger samples of ethnically homogeneous youth could be valuable. Another limitation involves the homogeneity of the sample in terms of language preference; over 90% of the sample completed the interview in English. Results may have differed had we included more participants who preferred Spanish. Thus, the generalizability of our findings to less acculturated Latino youth may be limited. A final limitation of this study is that the psychometric work was conducted in a single sample. The psychometric properties of the sexual values measures should be examined in future studies to confirm the scale properties.
Finally, it should be noted that the correlations between the sexual values measures and conceptually related variables (age, acculturation, sexual experience) ranged from small to moderate. Rather than being a limitation, however, these modest correlations confirm our suspicions that proxy measures, such as acculturation, should be avoided when relevant values can be measured directly. Our findings suggest that proxy measures tap into global concepts that are somewhat related to sexual values but are distinct. Thus, the degree of specificity that we have captured in the current measures may have important implications for theory building and intervention development.
Implications
The potential utility of the measures introduced in this study is considerable. Sexual values in the United States may be more permissive than in some Latino cultures; however, members of any cultural group subscribe to that culture’s norms to varying degrees and are not likely to endorse any norm equally (Raffaelli & Suarez-Al-Adam, 1998). Thus, some Latino youth may reject more traditional views of sexuality and incorporate liberal sexual values, whereas others may adopt fewer liberal sexual values while retaining some traditional values. Also, some youth may endorse traditional values in certain domains and more liberal values in others. To date, we have limited knowledge of what contributes to this process because few measures exist to assess specific sexual values among young Latinos. It is our hope that the measures developed in the current study will allow researchers to engage in a focused examination of sexual values and sexual risk behaviors to establish a better understanding of which values youth tend to preserve or relinquish over time and the extent to which these changes impact their behavior, enhance their sexual risk, or protect them from negative outcomes. Ultimately, utilization of specific sexual values measures may inform prevention models and future intervention efforts by helping identify and intervene with those youth who are at greatest risk for negative sexual behaviors and related poor health outcomes. In addition, future research using these measures has the potential to yield information about which sexual values are protective for youth.
Acknowledgments
An earlier version of this article was presented at the 2006 Biennial Meeting of the Society for Research on Adolescence. This research was supported by Grant R01AI49146 from the National Institute of Allergies and Infectious Diseases and training grants awarded from the National Institute of Mental Health (NIMH), T32MH019391, and the National Institute of Child Health and Human Development (NICHD) with the Office of Research on Women’s Health (ORWH), K12 HD052163-06.
We thank the participants in the Salud de Jovenes: Young Adult Health Research Project and the Kaiser Foundation Research Institute, which provided access to members of Kaiser Permanente. We are grateful to our project directors, Angela Gallegos-Castillo and Mimi Wolff, and to our research assistants, Adrian Aguilera, Janette Alvarez, Pedro Arista, Vanessa Avila, Nayeli Cerpas, Mario Garcia, Mateo Munoz, Alejandro Nuno, Diana Oliva, Saul Ramos, Raul Tejeda, and Cara Torruellas. Thank you to Seth Duncan and Cynthia de Groat for data management.
Contributor Information
Julianna Deardorff, Department of Epidemiology and Biostatistics, University of California, San Francisco.
Jeanne M. Tschann, Department of Psychiatry, University of California, San Francisco
Elena Flores, Department of Counseling Psychology, University of San Francisco.
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