RESUMO
BACKGROUND: The Multiracial population, defined as having parents who are of two or more racial groups, increased from 2.9% of the United States population in 2010 to 10.2% in 2020. Existing research focused on monoracial populations shows that racial disparities and discrimination affect health. This study explores how emerging adults ages 18-29, who identify as Multiracial, describe the impact of identity on their health and experiences seeking health care in the United States. METHODS: Semi-structured interviews were conducted with 21 participants in May 2021. Interview guide categories were the following: health and wellbeing, racial/ethnic identification, childhood upbringing, family influence, peer engagement, discrimination, forming resilience, language, and demographics. A thematic framework analysis was utilized. RESULTS: Overarching themes were as follows: mental health and Multiracial identity-related stress, childhood experiences, healthcare experiences, influences on seeking or not seeking care, and the impact of identity on physical health. Our findings suggest that Multiracial emerging adults perceive their identity to influence mental health more than physical health. CONCLUSION: Multiracial emerging adults face challenges with healthcare that are unique (e.g., discrimination based on identity defined or perceived by others) and others that are similar to their monoracial counterparts (e.g., structural racism, access to care). This study illustrates how structural factors trickle down to influence care sought and accessibility via socioeconomic status, insurance, childhood experiences, and racial and cultural beliefs about healthcare. Increased awareness and identification of Multiracial individuals and diversity in the workforce may help the US healthcare system better serve Multiracial emerging adults.
RESUMO
OBJECTIVE: Residents and fellows are often the first health.ßcare providers to discuss sexual health and prevention with adolescents and young adults at academic institutions. This study characterized when learners in Pediatrics, Obstetrics and Gynecology, and Family Medicine believed that one should receive training in pre-exposure prophylaxis (PrEP) and it described confidence in prescribing PrEP. METHODS: Learners at a large, urban, southern academic center completed an online survey about adolescent sexual health services. Measures included whether participants were taught how to prescribe PrEP and how to do so in a confidential manner. Confidence in these two behaviors was measured with a Likert scale and dichotomized for bivariate analysis. RESULTS: Among the 228 respondents (63% response rate), most learners preferred sexual health communication to be emphasized early in medical school and throughout training. Overall, 44% reported being ..únot confident at all..Ñ in prescribing PrEP, and 22% were ..únot confident at all..Ñ in prescribing in a confidential manner. Those who reported ..únot confident at all" in prescribing PrEP were more likely in pediatrics (51%) than family medicine (23%) or obstetrics-gynecology (35%) (P.ß<.ß.01). Those who had been taught how to prescribe were more confident in prescribing PrEP (P.ß..±.ß.01) and prescribing in a confidential manner (P.ß<.ß.01). CONCLUSIONS: Given the continued high rates of new human immunodeficiency virus infections among adolescents, effective communication with patients eligible for PrEP is critical. Future studies should evaluate and inform tailored curricula about the importance of PrEP and build communication skills around confidential prescribing.