Pro-pregnancy attitudes, history of pregnancy, and contraceptive service utilization influence homeless youths' effective contraception use

Background: Little research has been conducted in understanding male and female homeless youths' attitudes toward pregnancy and lifetime history of pregnancy/impregnating someone in relation to using effective contraception. Methods: As a part of a longitudinal study of Los Angeles area homeless youth, drop-in service seeking youth completed a self-administered online questionnaire and interviewer-led social network interview. The results presented are from the baseline interviews during the first two waves of data collection (N=642). Results: Thirty-nine percent of male and 56% of female respondents have ever impregnated someone/been pregnant. Twenty-two percent of homeless youth disagree or strongly disagree with the statement that getting pregnant or impregnating someone right now is “one of the worst things that could happen to you;” 28% feel “it wouldn't be all that bad” if they or their partner became pregnant; and 19% of homeless youth would like to become pregnant within the next year. Multivariate logistic regression, controlling for demographic characteristics,, found that homeless youth who accessed birth control or condoms in the previous month (OR: 2.91, p<0.001) and who have anti-pregnancy attitudes (OR: 1.17, p<0.001) are significantly more likely to report using effective contraception at last vaginal sex. Youth who have ever been pregnant or impregnated someone are significantly less likely (OR: 0.51, p<0.01) to report using effective contraception. Conclusions: As a substantial portion of homeless youth desire pregnancy/impregnating someone, contraception access may not be enough. Pregnancy prevention should continue, however programs should also promote healthy pregnancy habits and thus healthy birth outcomes.