(042) Barriers, Beliefs, and Access in Contraceptive Understanding and Use Among Filipino American Women of Reproductive Age (UNAWA Understanding Study)

Abstract Introduction The Philippines has one of the highest adolescent birth rates in Asia, and this trend persists among Filipinos who immigrate to the United States. Filipino American (FilAm) women experience higher rates of adolescent pregnancy compared to other Asian Pacific Islander subgroups, suggesting that the healthy immigrant paradox, where new immigrants often exhibit better health outcomes than native-born populations, does not confer protective benefits in this context. The Philippines’ history of Spanish colonialism and enduring sociopolitical influences continue to shape Filipino and FilAm moral and cultural attitudes towards sexual health, contraception, and abortion. These topics often remain taboo within Filipino households, where feelings of hiya (shame in Tagalog) may inhibit adolescents from seeking accurate sexual and reproductive health (SRH) information. Objective The study aimed to qualitatively explore the cultural, religious, and intergenerational factors shaping FIlAm women’s understanding of and access to contraception. Specifically, it sought to identify barriers and facilitators to obtaining contraceptive knowledge and to examine how FilAm women perceive access to reproductive health services. Methods A qualitative descriptive, interpretive approach was employed. Participants between the ages of 18 and 49 years old and who self-identified as Filipino American women were recruited from January 2023 to March 2023. Data were collected through 4 virtual focus groups (n = 13) and 14 individual interviews (n = 14) for a total of 27 participants. All sessions were conducted via Zoom and analyzed using inductive content analysis to identify emerging main themes. Results Four main themes emerged: (1) persisting culture and religious taboos perpetuating misinformation; (2) reliance on limited or informal sources for contraceptive guidance; (3) workaround strategies to access contraception due to fear of parental disapproval; and (4) intergenerational differences in openness towards sexual health discussions. Participants described a significant gap between parental expectations and comprehensive sex education, resulting in an inadequate understanding of contraception. Many sought alternative sources, such as peers, extended family members, online platforms, and university clinics, to fill these knowledge gaps. Findings underscore how the FIlAm immigrant experience influences reproductive decision-making, communication, and comfort surrounding sexual health topics. Conclusions Cultural and religious influences within Filipino American families continue to shape perceptions of contraception and sexual health, often reinforcing stigma and misinformation. Feelings of hiya and limited communication within families contribute to delayed or avoidant engagement with gynecologic and reproductive care. These findings highlight the need for culturally sensitive educational interventions and provider communication strategies to bridge intergenerational divides, reduce stigma, and promote informed contraceptive decision-making among FilAm women. Enhancing cultural competence among healthcare providers can strengthen trust, improve patient outcomes, and foster healthier dialogues around sexual and reproductive health in this community. Disclosure No.