Mi Cuerpo, Nuestra Responsabilidad: Using Photovoice to describe the assets and barriers to reproductive health among Latinos in North Carolina

In the US, Latinos experience worse outcomes compared to other groups for numerous health conditions, including chronic and infectious diseases, and injuries. The Latino community in North Carolina is growing rapidly and experiencing increasing disparities in reproductive health. According to 2010 statistics, in North Carolina Latinos have a higher rate of STIs than whites, with the HIV transmission rate four times that of whites. Partnering with a group of Latina Lay Health Advisors (promotoras), we used Photovoice to identify factors that affect sexual health in the Latino community in two counties in North Carolina. This iterative five-session participatory project used a structured empowerment-based process known as SHOWED to elicit themes. Academic and community partners conducted the content analysis together. The Lay Health Advisors (N=4) identified both structural- and individual-level barriers to sexual health, including language and documentation, availability and accessibility to resources, cultural taboos, and the role of men in reproductive health decisions. Participants presented results at a community forum and with input from community stakeholders created a plan of action to address the issues identified. The plan prioritized addressing the role of men in reproductive health as an action step for immediate work, with future endeavors focusing on reducing individual barriers to sexual health in the community. Empowering Latina Lay Health Advisors by building on their strengths and social resources to reduce the barriers to reproductive health is a viable approach and can increase community capacity to address disparities over the long-term.