Other Titles

Pregnancy Ambivalence, Contraceptive Use, and Lifetime Incidence of Pregnancy among a Sample of Youth Experiencing Homelessness in Houston, TX [Title Slide]

Abstract

Background: Youth experiencing homelessness (YEH) are 5-8 times more likely to become pregnant than their housed peers, with pregnancy estimates ranging from 30-60%. Similar to their housed peers, the majority of these pregnancies are unintended, a factor associated with negative health, economic, and social outcomes. Contraceptive use has been considered the behavioral link between attitude toward pregnancy and incidence of pregnancy; however, recent studies suggest that pregnancy attitudes and contraceptive use behaviors may be less consistent than previously thought, especially for marginalized individuals, such as YEH.

Purpose: The purpose of this study is to describe pregnancy ambivalence, pregnancy, and contraceptive use among YEH.

Methods: Cross-sectional data was collected at baseline during a randomized wait-list controlled trial to assess the efficacy of an HIV prevention intervention among YEH (n=450). Demographics, lifetime incidence of pregnancy, and contraceptive use were assessed by single items. Pregnancy ambivalence was measured using three Likert scale questions assessing feelings and preferences about becoming pregnant.

Results: The sample (n=450) had an average age of 21.1 years, was majority Black (62%) or Hispanic (16%); 50% male, 44% female, and 6% other gender. Most of the sample reported having sex in the last 3 months (68%). Over a third (39%) reported ever being pregnant and 15% reported currently using contraceptives. Correlation analyses will examine the relation between pregnancy ambivalence, incidence of pregnancy, and contraceptive use.

Conclusion: Results of this study highlight pregnancy ambivalence, contraceptive use, and the experience of pregnancy in YEH. Understanding pregnancy attitudes and correlations with contraceptive use may help nurses support contraception decision making and inform policies and programs that are responsive to the needs of YEH.

Notes

References:

Eapen, Doncy J., et al. "Experiences of pregnancy prevention among youth experiencing homelessness." Children and Youth Services Review 153 (2023): 107115.

Kachingwe, Olivia N., et al. "‘I told him I’m gonna get it’: intimate partner birth control communication among homeless young women." Culture, health & sexuality 25.2 (2023): 159-175.

Manze, Meredith G., et al. "The association of pregnancy control, emotions, and beliefs with pregnancy desires: a new perspective on pregnancy intentions." PloS one 16.3 (2021): e0249032.

Santa Maria, Diane, et al. "A nurse case management HIV prevention intervention (come As you are) for youth experiencing homelessness: Protocol for a randomized wait-list controlled trial." JMIR research protocols 10.5 (2021): e26716.

Sheeder, Jeanelle, et al. "Adolescent childbearing ambivalence: is it the sum of its parts?." Journal of Pediatric and Adolescent Gynecology 23.2 (2010): 86-92.

Description

This presentation will share findings of pregnancy ambivalence, pregnancy, and contraceptive use among Youth Experiencing Homelessness (YEH) aged 17-25 from a large urban area. Over a third of the sample had experienced a pregnancy and the potential negative health outcomes associated with unintended pregnancy. Attendees will gain a better understanding of how pregnancy ambivalence is associated with contraceptive use and pregnancy and how nurses can support contraceptive decision-making.

Author Details

Diane Santa Maria, DrPH, RN; Mary Catherine Lingwall, MPH, BSN

Sigma Membership

Zeta Pi

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Randomized Controlled Trial

Research Approach

Quantitative Research

Keywords:

Public and Community Health, Health Equity or Social Determinants of Health, Mentoring and Coaching, Pregnancy Ambivalence, Contraceptive Use, Youth Experiencing Homelessness, Houston, Texas

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

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Pregnancy Ambivalence, Contraception, and Pregnancy Incidence Among Youth Experiencing Homelessness

Seattle, Washington, USA

Background: Youth experiencing homelessness (YEH) are 5-8 times more likely to become pregnant than their housed peers, with pregnancy estimates ranging from 30-60%. Similar to their housed peers, the majority of these pregnancies are unintended, a factor associated with negative health, economic, and social outcomes. Contraceptive use has been considered the behavioral link between attitude toward pregnancy and incidence of pregnancy; however, recent studies suggest that pregnancy attitudes and contraceptive use behaviors may be less consistent than previously thought, especially for marginalized individuals, such as YEH.

Purpose: The purpose of this study is to describe pregnancy ambivalence, pregnancy, and contraceptive use among YEH.

Methods: Cross-sectional data was collected at baseline during a randomized wait-list controlled trial to assess the efficacy of an HIV prevention intervention among YEH (n=450). Demographics, lifetime incidence of pregnancy, and contraceptive use were assessed by single items. Pregnancy ambivalence was measured using three Likert scale questions assessing feelings and preferences about becoming pregnant.

Results: The sample (n=450) had an average age of 21.1 years, was majority Black (62%) or Hispanic (16%); 50% male, 44% female, and 6% other gender. Most of the sample reported having sex in the last 3 months (68%). Over a third (39%) reported ever being pregnant and 15% reported currently using contraceptives. Correlation analyses will examine the relation between pregnancy ambivalence, incidence of pregnancy, and contraceptive use.

Conclusion: Results of this study highlight pregnancy ambivalence, contraceptive use, and the experience of pregnancy in YEH. Understanding pregnancy attitudes and correlations with contraceptive use may help nurses support contraception decision making and inform policies and programs that are responsive to the needs of YEH.