Socio‐Structural Factors Shaping Adolescent Mothers' Sex Education: A Qualitative Secondary Analysis

Sex education is a vital component of healthy adolescent development, yet its effectiveness is often compromised by socio-structural factors, particularly among marginalized youth. In New York City, Black and Hispanic adolescents face disproportionately adverse sexual and reproductive health outcomes (highest rates of births/sexually transmitted infections). This qualitative secondary analysis explores how socio-structural factors within educational, healthcare, and community contexts influence Black and Hispanic adolescent mothers' access, understanding, and application of sex education. Directed content analysis, guided by the socio-ecological model, was performed on semi-structured interview data from 16 Black and Hispanic adolescent mothers (14-19 years old) to examine factors at the individual, interpersonal, organizational, community, and structural levels. Interconnected barriers were revealed across all levels. Individually, untimely education and emotional readiness were key challenges, although motherhood acted as a transformative catalyst. While interpersonal and community barriers included parental taboos and social stigma, organizational gaps in curricula and provider training were compounded by structural factors of race and socioeconomic status, leading to marginalized access. Sex education for this population is undermined by these systemic barriers, demanding consistent, culturally sensitive programming.