What Are Foster Youth’s Most Pressing Sexual Health Needs?

Diverse young women.

Perceived Benefits and Proposed Solutions for Teen Pregnancy: Qualitative Interviews With Youth Care Workers.” Maya Mroué Boustani, Stacy L. Frazier, Chelsey Hartley, Michael Meinzer, and Erin Hedemann. American Journal of Orthopsychiatry, Vol. 85, No. 1 (January 2015).

What it’s about: Researcher Maya Mroué Boustani and her colleagues spoke to 10 youth workers to learn their views on how to better prevent pregnancy among foster youth. The youth workers practiced in two shelters in a large city in the southeastern United States. Their clients were an equal mix of girls and boys from low-income minority families.

Each 30-minute interview consisted of open-ended questions about “the perceived costs and benefits of teen pregnancy among youth in or at risk for foster care.” In other words, why might a youth in this situation not practice safe sex? Or, in some cases, why might they choose to become pregnant on purpose?

Why read it: Former and current foster youth are at higher risk for becoming a teen parent than their peers who have never lived in foster care. The pregnancy rate for teen girls in foster care is twice the rate of girls not in foster care. Despite these statistics, few teen pregnancy prevention programs have been designed to meet the needs of youth in foster care. Through their interviews with adults who work closely with foster youth, the authors shed light what those needs are, and how a prevention program might address them.

Biggest takeaways from the research: The youth workers identified some of the factors that put foster youth at risk for too-early pregnancy, including:

  • Lack of family functioning and positive adult presence: Violence and instability at home may deprive young people of a model of healthy relationships.
  • Lack of sexual health knowledge: Poor understanding of the risks of sexual activity may lead to increased (and often unaware) risk-taking.
  • Life stressors and related trauma: Homelessness, experience in the foster care or child welfare system, victimization, and exposure to violence commonly may result in a lack of impulse control.
  • Peer pressure
  • Physical drive to have sex

The researchers also said many youth feel there are potential benefits to pregnancy, including:

  • Emotional bond with baby: Young girls without reliable or supportive families might long to start a family of their own.
  • Staying connected to their romantic partner: Similarly, a baby might be a way to stay connected to a boyfriend or girlfriend.
  • Financial incentives: The perception that a baby will increase their access to social services and help them stabilize their life.
  • Desire for independence: A baby is perceived as a way out of traumatic home situations.

In short, the authors say, “staff perceive youth may overestimate the benefits and underestimate the costs of being a teen parent.”

What's needed, the authors suggest, are foster youth-specific teen pregnancy prevention programs that target more directly young people's ambiguous desire for pregnancy. To that end, the authors recommend (1) employing staff with who share a similar background as the youth, in order to speak to specific cultural perceptions around pregnancy, and (2) including explicit cost-benefit exercises as part of a pregnancy prevention curriculum.

Additional references: The NCFY library contains many studies related to foster youth. NCFY previously covered two studies about the risk of homelessness for foster youth and the reasons for that high risk. A researcher from Child Trends also spoke to us about the challenges of teaching foster youth about healthy relationships.

Publications discussed here do not necessarily reflect the views of the National Clearinghouse on Families and Youth, the Family and Youth Services Bureau, or the Administration for Children and Families.

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