Homeless youth have disproportionately high rates of unintended pregnancy and STIs. Enhancing communication between sexual partners can improve sexual health outcomes, yet little is known about this ...topic among homeless youth; therefore, this study aimed to examine how homeless youth communicate with their partners about birth control. In-depth semi-structured interviews regarding intimate partner birth control communication were conducted with 10 homeless young women aged 14-22 years following their completion of a comprehensive sexual health program (Wahine Talk). We transcribed the interviews verbatim and used a structured, inductive analytic approach to identify themes. Analysis identified three themes: Getting the Conversation Started, Conversation Content, and Impact of Conversation. Birth control conversations were prompted by programme participation, birth control side effects, and family members' interest in homeless youth becoming pregnant. Barriers to communication included fear and mistimed conversations (e.g. during the initiation of sex). Homeless young people shared simultaneous desires to delay pregnancy and concerns about side effects of birth control use. Discussions about birth control with their partners may demonstrably improve homeless youth's intimate relationships and family planning efforts. Providers can support homeless young women by helping them plan conversation timing and addressing fear, including the risk of violence.
Nearly half of female youth experiencing homelessness (YEH) become pregnant due to myriad individual, family, community, and structural factors. In response, our team developed and tested Wahine ...(“woman”) Talk, a multilevel, trauma-informed sexual and reproductive health intervention created with and for female YEH aged 14 to 22. After Wahine Talk, youth were invited to participate in a participatory action PhotoVoice project regarding experiences of the program, waiting to start or expand their families, and homelessness. Photographs were taken and captioned by youth, and then further examined through Thematic Analysis. Final project themes include (a) Youth-Driven Birth Timing Decisions; (b) A Sense of Place: Finding Safe Spaces; and (c) Glimpsing Hope. Because YEH live under society’s radar, it is critical to understand their experiences from their own perspectives to improve interventions at multiple levels. Implications for meeting the needs of YEH in the areas of reproductive justice, financial stability, and affordable housing are discussed.
•Foster youth use social media to establish and maintain intimate relationships.•Trust plays an integral role in how foster youth interact with others online.•Social media use can result in intimate ...partner violence and breached privacy.•Foster youth take concrete steps to protect themselves while online.•Parents and staff need further training on how best to support foster youth online.
•Birth control use among female youth who are homeless triples following Wahine Talk.•LARC and Depo-Provera were the most popular birth control methods selected.•Wahine Talk is a feasible and ...acceptable multilevel, trauma-informed SRH program.
Female youth experiencing homelessness are at high risk for pregnancy due to a host of individual, family, and community-level risk factors. This embedded mixed-method quasi-experimental pilot study examined the initial outcomes of Wahine (woman) Talk, a comprehensive sexual health program delivered by an interdisciplinary team to female youth experiencing homelessness. Wahine Talk includes provision of and connection to basic needs resources, peer mentoring, group based sexual health education, and linkage to and provision of sexual health care. Process and outcome data were collected throughout and for six months after Wahine Talk from a diverse group of 14–22-year-old female youth (N = 51) experiencing homelessness. In-depth individual and focus group interview data were collected from providers and youth after Wahine Talk, and analyzed using Template Analysis. Over half (62.7%) of participants were linked to sexual health care during Wahine Talk and birth control usage tripled following the program. Depo-Provera and long acting reversible contraception (LARC) usage, in particular, increased during Wahine Talk (1–19% and 0–25.5%, respectively). Within six months, 31.4% of youth had adopted LARC and 3.9% were using Depo-Provera. Individual and focus group interviews with providers and youth affirm program acceptability and appropriateness.
Introduction
US foster youth have elevated pregnancy and sexually transmitted infection (STI) rates, yet receive limited sexual health education and intervention. Thus, we sought to co-develop a ...comprehensive model of sexual health needs among youth in foster care group homes through a community-engaged research process with foster youth and foster care staff to inform such intervention.
Methods
Our team conducted five in-depth focus groups with both foster youth placed in group homes and foster care staff (social workers and group home staff) in 2018–2019. We analyzed the data through iterative open, focus, axial, and selective/theoretical coding using constructivist grounded theory (GT) methods to produce a model of sexual health needs among youth in foster care group homes.
Results
GT analysis revealed the model’s core category, Addressing Sexual Health among Youth in Foster Care Group Homes, has three supporting categories: reproductive health system, relationship health, and mental health.
Conclusions
The study model offers new pathways for comprehensively addressing sexual health and well-being in this specialized population, grounded in foster youth and staff members’ direct, lived experiences.
Policy Implications
This conceptualization expands current intervention options beyond pregnancy/STI education programs alone to a holistic, multilevel focus on the interrelated need for trauma-informed family planning and contraception care, mental health and substance use care, sexual and emotional safety, and healthy relationships.
Homeless female adolescents in the United States have disproportionately high rates of pregnancy compared to general population youth. Little is known about how homeless youth decide whether to use ...birth control and which birth control method to select. The current study explores how homeless female youth participating in a holistic sexual health program called Wahine (“woman”) Talk experience this process, using data from in-depth interviews (N = 3) with 11 homeless adolescent girls. Data were analyzed using Interpretative Phenomenological Analysis, proceeding through reading and re-reading, initial noting, forming emergent and super-ordinate themes, repeating steps for each interview, and developing final themes and subthemes. Four final themes emerged, which, for most participants, were experienced sequentially: Getting Acclimated, Becoming Close and Building Trust, Addressing Fear, and Making the Choice. Study findings suggest that for homeless female youth, basic needs and relationship building must be addressed prior to the delivery of trauma-informed birth control-related content and effective linkage to (sexual) healthcare. Implications for practice, policy, and future research are discussed.
•The rate of homeless teen pregnancy is five times greater than the general youth population.•Little is known about how homeless youth experience accessing and selecting birth control.•For study participants, accessing and selecting birth control contains four steps experienced sequentially.•Homeless youth perceive risk of sexual assault/unwanted pregnancies, which motivates accessing birth control.•Meeting basic needs and building a trusted relationship is critical for trauma-informed healthcare for homeless youth.
Purpose: Youth homelessness is a severe problem in the United States, wherein 4.3% of 13-17-year olds and 12.5% of 18-25-year olds experienced homelessness in the past year. Compared to the general ...U.S. population, homeless female youth are five times more likely to become pregnant. Limited research exists about the social networks of homeless youth, which can provide access to resources and information, as well as influence behaviors. The current study was designed to better understand social network properties among homeless female youth as they participated in a teen pregnancy prevention program. Methods: The study used a social network analysis (SNA) to assess the quality and strength of relationships between program participants. SNA was an ideal technique because the study population was part of a network bounded by program participation. 11 participants (n=11) took part in data collection who were 14 to 18 years old. Most participants were sexually active (n=9) and first engaged in consensual sex at 13 to 18 years (M=15 years) of age. None of the participants were using birth control before the start of the program. To illustrate the connections among our sample, we created three unique networks. This was achieved by giving participants a roster of everyone in the study and asking who they knew (closeness), if they trusted them (trust), and if they shared information about sexual health. Quadratic assignment procedures (QAP) correlation analyses compared closeness and trust networks with the information sharing network, revealing how similar connections were between networks. QAPs are permutation tests that analyze bivariate correlations between two or more networks. Results: At the end of the program, there was a 73% uptake of birth control at the one-month post. QAP correlations revealed that trust was positively, but weakly associated with sharing information about sexual health (QAP r= 0.36, p=.008). QAP correlations also indicated that sharing information about sexual health was not associated with the closeness or knowing the other participants (QAP r=0.007, p=.157). Lastly, QAP correlation analysis showed that closeness was weakly and negatively associated to trust in other participants (QAP r=-0.114, p=.056). Conclusions: Results show the trust network and the information sharing network were significantly correlated in our sample, suggesting homeless, female youth are more likely to share information about sexual health to the people they trust, but not necessarily to those they are close to. Further, the closeness and trust networks were negatively correlated, indicating youth did not trust those they were closest to. While we expected trust and information sharing networks to be correlated, the negative correlation between trust and closeness was surprising. A gap between closeness and trust could be because homeless youth tend to be hurt or ostracized by previous close relationships, or because they are protective of themselves and their belongings, inhibiting trust to formulate when people get too close. Future research could further examine this social phenomenon in our population and result in better health programming and interventions for homeless youth.
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