Homeless Women: Who is Really at Risk for Unintended Pregnancy?

Abstract

Objective To identify correlates of failure to use contraception among homeless women at risk for unintended pregnancy. Study Design A representative sample of 974 homeless women surveyed in Los Angeles County in 1997 included 457 who were at risk for unintended pregnancy. Logistic regression modeling was used to identify important predictors of contraceptive nonuse or rare use in the past year. Results One third of the sample used contraception rarely or never in the past year. Having a partner, being monogamous, and not engaging in sex trade predicted contraceptive nonuse or rare use (odds ratios 2.43-4.73, P \ .05). Partner dislike and uncertainty about which contraceptive to use were also associated with failure to use contraception (odds ratios 2.64-2.96, P \ .05). Having a regular source of care and having been encouraged to use contraception protected against failure to use contraception. Conclusions Homeless women, including those at apparently low risk for unintended pregnancy, need to be targeted with integrated services that include education, a regular source of medical care, and encouragement to use contraception.

A Qualitative Study of Pregnancy Intention and the Use of Contraception among Homeless Women with Children

“…9 Among the homeless women using contraception, 92% relied primarily on condoms and only 32% of those reported using condoms with every sexual encounter. 10 In contrast, approximately 50% of all pregnancies in the United States are unintended and only 10% of women in the general population practicing contraception used condoms as their most effective method of birth control. 11,12 …”

The Paradox of Homeless Youth Pregnancy: A Review of Challenges and Opportunities

“…To date, most extant research efforts have cross-sectionally examined pregnancy prevalence and associated risk factors among homeless women, most frequently investigating topics such as contraception use and risky sexual activity (Gelberg et al, 2008;Halcón & Lifson, 2004;Solorio et al, 2008;Thompson et al, 2008;Unger et al, 1998).…”

“…Highlighting some examples, in a representative sample of 974 homeless women (of all ages), one-third reported rare or no use of contraception in the prior year despite sexual activity, citing barriers that were positively correlated to contraception non-use, such as not knowing how to use contraceptives and contraception cost (Cauce et al, 2005;Gelberg et al, 2008;Hathazi et al, 2009). In another study, 42% of sexually active homeless women said they did not use any form of birth control in the prior 12 months (Arangua, Andersen, & Gelberg, 2005), while researchers have found that 95% of homeless females are sexually active (Nyamathi, 1993).…”

Meeting Them Where They Are: An Exploratory Study of Staff and Shelter Resident Perceptions of Homeless Women's Needs

“…Researchers have advised service providers to make available physical health (Gelberg et al, 2008), mental health (Christensen et a l., 2005), substance abuse (Kertesz et al, 2007), case management (Desai & Rosenheck, 2005), nutrition planning (Richards & Smith, 2006), contraception and family planning (Gelberg et al, 2008), syringe exchange (Heller et al, 2009), and oral health (Conte et al, 2006) services to members of this population. Some have made specific policy recommendations as well (Richards & Smith, 2006).…”