Reproductive health of homeless adolescent women in Seattle, Washington, USA.

OBJECTIVES: Homeless adolescent women are at high risk for negative health outcomes including early unplanned pregnancy and sexually transmitted diseases. The purpose of this study was to hear the perspectives of homeless adolescent females on the topics of health issues, self-care and fertility control, as well as on lessons from being homeless.
DESIGN: The rescarch was descriptive, using semi-structured interviews and focus groups with a purposeful sample of 20 clinic-based female youth ages 15-23 years. The data were coded and analyzed following standard qualitative tcchniques.
RESULTS: The youth described female-specific health issues of being homeless, such as problems with hygiene, sexual exploitation, survival sex. Most knew of homeless female youth who had tried self-induced abortions through drugs, herbs or physical abuse. They spoke of fertility control practices of young women living on the streets. The women also spoke of the lessons they had learned while being homeless, including the development of self-sufficiency.
CONCLUSIONS: The young women in this study were willing to discuss their perspectives and experiences of being homeless. Health care providers should receive increased training in how to ask about sensitive subjects such as survival sex and the practice of self-induced abortions. Programs should be structured to ensure engagement of the women in healthy relationships with adults.