title: Barriers to sexual and reproductive health care: urban male adolescents speak out.
abstract: BACKGROUND
  Risky sexual behaviors among adolescent males put them at risk for sexually transmitted diseases, HIV/AIDS, and unplanned fatherhood, yet few facilities in the United States provide focused sexual and reproductive health services to these young men. A general acknowledgement exists that the development of such services is needed, yet there is little research to guide providers in making existing services more attractive to young males and in developing new sexual health services for this population.
  
  
  OBJECTIVE
  This research aimed to explore attitudes and perceptions of urban black male adolescents regarding the availability of and access to reproductive healthcare.
  
  
  METHODS
  Eighteen black male adolescents participated in three focus group discussions held in a central New Jersey city. Transcripts of the discussions were analyzed using the constant comparative method. Resulting categories were grouped into themes, which reflected the adolescents' perceptions and experiences. Member checks were used to verify findings.
  
  
  RESULTS
  The adolescents felt that obtaining sexual health services was a stressful experience fraught with both internal and external barriers. Internal barriers included a fear of stigma and a loss of social status, shame, and embarrassment. External barriers included disrespectful providers, a lack of privacy/confidentiality, and challenges in accessing and negotiating the healthcare system. The young males described an idealized clinic environment as informal, welcoming, and respectful.
  
  
  CONCLUSIONS
  Providers should focus on improving the quality of care in existing clinics, particularly in the areas of access, privacy, and confidentiality, and on developing adolescent-friendly clinics focusing on male services. Adolescents should be encouraged to visit clinics prior to an acute need for services. There also is a need for providers who are comfortable with and able to communicate with male adolescents.
authors.affiliation: School of Nursing, The College of New Jersey, Ewing, New Jersey, USA. clindberg6@comcast.net
authors.forename: Claire
authors.initials: C
authors.lastname: Lindberg
authors.forename: Carolyn
authors.initials: C
authors.lastname: Lewis-Spruill
authors.forename: Rodney
authors.initials: R
authors.lastname: Crownover
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards; D001741:Black or African American / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology*; D003219:Confidentiality; D017144:Focus Groups; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000592:standards*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008571:Men / Q000523:psychology*; D009515:New Jersey; D015404:Nursing Methodology Research; D011369:Professional-Patient Relations; D000297:Psychology, Adolescent; D036301:Qualitative Research; D034121:Reproductive Health Services / Q000592:standards*; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology; D012752:Shame; D013240:Stereotyping; D011795:Surveys and Questionnaires; D019037:Urban Health Services / Q000592:standards*