Listening to Immigrant Latino Men in Rural Oregon: Exploring Connections between Culture and Sexual and Reproductive Health Services

New settlement areas in rural parts of the Pacific Northwest are experiencing dramatic growth in the number of new, mainly male Latino immigrants. These men face a number of distinct challenges that may influence sexual risk behaviors and use of sexual and reproductive health services (SRHS), putting them at risk for sexually transmitted infections (STIs) and HIV/AIDS. Addressing disparities in sexual and reproductive health (SRH) among Latinos entails understanding their attitudes and perceptions from a cultural viewpoint. In this study, we explored if and how men's actions and perspectives related to SRHS were shaped by a) being a new immigrant; and/or b) beliefs and practices that they viewed as traditional or representative of the larger Latino culture. Semi-structured interviews were conducted in English or Spanish with 49 heterosexual, sexually active men (ages 18-30) who recently immigrated to the U.S. and resided in rural Oregon. Using content analysis we found individual-level barriers to SRHS included men's lack of general knowledge of SRH and where to access SRHS, as well as their perception of personal risk of STIs/HIV and their attitudes about SRHS. On a structural/service delivery-level, the importance of privacy and confianza; the need for respectful interactions and treatment with health care providers; actual or perceived cost of services; and the need for Spanish speaking providers or translators, were dominant themes. Results provide a unique cultural lens through which to examine the SRH needs of immigrant Latino men and to address factors that affect their access and use of SRHS.