The Importance of Culturally Competent Sexual Health Education
Sexual health education is an incredibly important aspect of healthcare, yet, over the past decade, efforts to train medical students about this concept have decreased, and there is no fomal consensus about how and what should be taught. As the United States's population becomes more culturally and ethnically diverse, it is even more imperitive that physicians are able to provide culturally competent medical education.
Sexual health is a taboo topic in many immigrant communities, namely for Asian Americans. In an interview-based survey of 20 young Asian Americans between 14 and 18 years old, half of the respondents stated that they were sexually active, however, only a few had conversations about sex, contraception, and STIs with their physician in the last two years. None had talked about pregnancy prevention. In addition, they rarely spoke about sex with their parents. This is a stark contrast compared to non-Asian youth and is likely due to cultural stigmas about the topic.
The model minority myth causes many physicians to assume that Asian Americans have a lower risk for unplanned pregnancy and sexually transmitted infections (STIs). This, combined with a lack of discussions with family members, greatly disservices Asian American youth and their sexual health education. In fact, Asian Americans have a higher use of abortion services, higher rates of cervical cancer, lower rates of HIV testing, and less knowledge about sexual health overall, pregnancy prevention, and STIs.
One large issue affecting Asian American youth, and women specifically, is a low rate of condom usage. This can be due to the power dynamics in Asian culture where women may be less assertive in using protection. One study highlighted how birth control was used more commonly than condoms, indicating that people may have been more focused on preventing pregnancy, potentially to avoid stigma and shame, compared to preventing STIs.
In order to eliminate these disparities, physicians must create a supportive environment to discuss sexual health and their activity. Researchers found that physicians would be more successful in having these conversations if they ensured confidentiality, developed longitudinal relationships with patients, and initiated conversations about sexual health with sexually active and non-sexually active teens.
It can be difficult for teenagers to speak up and seek the sexual health education they need, and if physicians are unfamiliar with Asian culture and stigmas, these conversations would be left unhad. Caralyst is working to match patients with physicans who can address their needs and provide culturally competent care.