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.

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Acknowledgements

This research was supported by a grant from the Agency for Health Care Policy and Research (R01 HS08323) and a grant from the Robert Wood Johnson Foundation. Dr. Gelberg was a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar at the time of this study and the George F. Kneller Professor of Family Medicine. Dr. Lu is a Women’s Reproductive Health Career Development Fellow supported by the National Institutes of Health. Drs. Gelberg and Andersen are members of the National Academy of Sciences, Institute of Medicine. The authors wish to thank Ellen Silk for providing assistance with this manuscript.

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Correspondence to Lillian Gelberg.

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Gelberg, L., Lu, M.C., Leake, B.D. et al. Homeless Women: Who is Really at Risk for Unintended Pregnancy?. Matern Child Health J 12, 52–60 (2008). https://doi.org/10.1007/s10995-007-0285-1

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Keywords

  • Homeless persons
  • Contraception
  • Women’s health