Based on their degree of acculturation, Hispanic millennials exhibit different levels of sexual risk behaviors. The language spoken by Hispanic millennials and their place of birth likely determines attitudes and behaviors in regards to sex, says a study conducted by the Journal of Adolescent Health.

The study, which focused on sexual behavior and health care access of Latino youth and millennials, examined four groups of participants: 1) Spanish-speaking Hispanic immigrants; 2) English-speaking Hispanic immigrants; 3) U.S.-born Hispanics, who spoke English.); and 4) U.S.-born non-Hispanic whites who spoke English.

According to the research, Spanish-speaking immigrants ages 15 to 24 were likelier to report that they'd experienced vaginal sex than English-speaking immigrants, U.S. born Hispanics or non-Hispanic whites. In the case of vaginal intercourse, only half of Spanish-speaking immigrants used a condom during their first sexual experience. That's compared to more than two-thirds of English-speaking immigrants and native-born Hispanic youth, who reported that they'd used a condom.

Approximately 63 percent of all youth reported having vaginal sex, but that number jumped to 76 percent when asking only Spanish-speaking immigrants. Also, Spanish-speaking immigrants were 17 percent likelier to have their first sexual encounter (via vaginal sex) with a partner that was six or more years older than themselves (27 percent versus less than 10 percent for the other three groups).

U.S.-born Hispanics and non-Hispanic whites are more likely than Spanish-speaking immigrant youth and millennials to have a place where they can survey health and receive regular health care for the prevention and treatment of sexually transmitted infections (STIs). Non-Hispanic white youth, on average, (70 percent) indicated that they had private coverage, while a stunning 65 percent of Spanish-speaking immigrants reported that they had no health insurance at all. With access to health care, U.S. born Hispanics and non-Hispanics were more likely to report that they had a chlamydia test within the past year.

Laura Haderxhanaj, MPH, MS, an Oak Ridge Institute for Science and Education fellow with the Centers for Disease Control and Prevention, who led the study, noted that Hispanic youth tended to face economic and social barriers, such as poverty, which reduced access to healthcare. Also, those barriers heighten the risk for sexually transmitted diseases, unwanted pregnancies and other sexual health problems. Haderxhanaj added, for young Latinos, "little is known about how acculturation, or the process of assimilating into a new culture, impacts risk factors and health disparities."

"These findings on disparities in sexual behavior and health care access for Spanish-speaking immigrants reinforce the need to increase the number of culturally competent sex education programs for Latino/Latina youth," said Leslie Kantor, MPH, vice president of education at the Planned Parenthood Federation of America, which offers culturally diverse sexual education programing for youths and adults, including programing in Spanish.

Although Obamacare advocates have targeted the Hispanic community, it's evident that Hispanic immigrants, particularly Spanish-speaking immigrants, are not getting the message.

According to Angela Franco, president and CEO of the Greater Washington Hispanic Chamber of Commerce, her organization has "literally been going door to door" to spread awareness of President Obama's health care law and to help the uninsured become insured. Nonetheless, Spanish-speaking youth continue to unwittingly make sexual decisions that will affect the rest of their lives, because they simply don't know better.

Nearly a quarter of those who are uninsured and eligible for coverage under ACA are Hispanic. At the same time, many who are uninsured and ineligible for coverage are also Hispanic. And both segments need to be engaged about consent, safe sexual practices, health, hygiene and wellness, in English and in Spanish.