Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter October 13, 2017

Sexual behavior and pregnancy among adolescents in foster family homes

  • Weihai Zhan EMAIL logo , Susan R. Smith , Lynette C. Warner , Fred North , Sara Wilhelm and Amanda Nowak

Abstract

Objective

To examine the prevalence of and factors associated with sexual behavior and pregnancy involvement among adolescents in foster family homes.

Methods

A cross-sectional study was conducted among a random sample of children living in foster family homes. Logistic regression with Firth’s correction was used to determine factors associated with sexual risk behavior and pregnancy involvement (i.e. having been pregnant or gotten someone pregnant).

Results

About half of adolescents (aged 13–18 years) in foster family homes ever had sex, of whom, one third had first sex before the age of 14 and one sixth had two or more sexual partners in the past 3 months. Of adolescents in the study, 9% had ever been pregnant or gotten someone pregnant. Although adolescents in foster family homes had higher rates of sex initiation and pregnancy involvement than those in the general population, the two groups had comparable rates of current sexual risk behavior. Being placed in kin/fictive kin foster homes [odds ratio (OR): 3.04; 95% confidence interval (CI): 1.18–7.80] and number of placement settings (OR: 1.20; 95% CI: 1.02–1.42) were associated with multiple sexual partners, while a history of running away from a foster home (OR: 7.64; 95% CI: 1.87–31.18) was associated with pregnancy involvement.

Conclusions

Efforts targeting placement stability including prevention of running away may reduce sexual risk behavior and pregnancy involvement among adolescents in foster family homes.

Acknowledgments

The authors thank Connecticut Association of Foster and Adoptive Parents for their partnership, DCF Adolescent and Juvenile Services Division for financial support and Connecticut Department of Public Health for providing comparison data. We also thank the support of hundreds of foster children, foster parents, DCF staff and administration.

References

[1] Klein JD. Adolescent pregnancy: current trends and issues. Pediatrics. 2005;116(1):281–6.10.1542/peds.2005-0999Search in Google Scholar PubMed

[2] Ventura SJ, Abma JC, Mosher WD, Henshaw SK. Estimated pregnancy rates for the United States, 1990-2005: an update. Natl Vital Stat Rep. 2009;58(4):1–14.Search in Google Scholar PubMed

[3] Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health. 2015;56(2):223–30.10.1016/j.jadohealth.2014.09.007Search in Google Scholar PubMed

[4] Hoffman SD, Maynard RA. Kids Having Kids: Economic costs and social consequences of teen pregnancy. Washington DC: The Urban Institute, 2008.Search in Google Scholar

[5] Coley RL, Chase-Lansdale PL. Adolescent pregnancy and parenthood: recent evidence and future directions. Am Psycholog. 1998;53(2):152.10.1037/0003-066X.53.2.152Search in Google Scholar

[6] Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics. 2004;113(2):320–7.10.1542/peds.113.2.320Search in Google Scholar PubMed

[7] Hoffman SD. By the numbers: The public costs of teen childbearing. Washington, DC: National campaign to prevent teen pregnancy, 2006.Search in Google Scholar

[8] Dworsky A, Courtney ME. The risk of teenage pregnancy among transitioning foster youth: Implications for extending state care beyond age 18. Child Youth Serv Rev. 2010;32(10):1351–6.10.1016/j.childyouth.2010.06.002Search in Google Scholar

[9] U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Children’s Bureau. The AFCARS Report: Preliminary FY 2015 Estimates as of June 2016. Available at: https://www.acf.hhs.gov/sites/default/files/cb/afcarsreport23.pdf.Search in Google Scholar

[10] Carpenter SC, Clyman RB, Davidson AJ, Steiner JF. The association of foster care or kinship care with adolescent sexual behavior and first pregnancy. Pediatrics. 2001;108(3):e46–e.10.1542/peds.108.3.e46Search in Google Scholar

[11] Akin BA. Predictors of foster care exits to permanency: A competing risks analysis of reunification, guardianship, and adoption. Child Youth Serv Rev. 2011;33(6):999–1011.10.1016/j.childyouth.2011.01.008Search in Google Scholar

[12] Smith BD. After parental rights are terminated: Factors associated with exiting foster care. Child Youth Serv Rev. 2003;25(12):965–85.10.1016/S0190-7409(03)00105-1Search in Google Scholar

[13] Fallesen P. Time well spent: The duration of foster care and early adult labor market, educational, and health outcomes. J Adolesc. 2013;36(6):1003–11.10.1016/j.adolescence.2013.08.010Search in Google Scholar PubMed

[14] Zhan W, Smith SR, Warner LC, North F, Wilhelm S. Cigarette, alcohol, and marijuana use among adolescents in foster family homes. Child Youth Serv Rev. 2016;69:151–7.10.1016/j.childyouth.2016.08.009Search in Google Scholar

[15] Blum RW, Beuhring T, Shew ML, Bearinger LH, Sieving RE, Resnick MD. The effects of race/ethnicity, income, and family structure on adolescent risk behaviors. Am J Publ Health. 2000;90(12):1879.10.2105/AJPH.90.12.1879Search in Google Scholar PubMed PubMed Central

[16] Lauritsen JL. Explaining race and gender differences in adolescent sexual behavior. Soc Forces. 1994;72(3):859–83.10.1093/sf/72.3.859Search in Google Scholar

[17] Zimmer-Gembeck MJ, Helfand M. Ten years of longitudinal research on US adolescent sexual behavior: Developmental correlates of sexual intercourse, and the importance of age, gender and ethnic background. Development Rev. 2008;28(2):153–224.10.1016/j.dr.2007.06.001Search in Google Scholar

[18] Levin JR, Serlin RC. Changing students’ perspectives of McNemar’s test of change. J Stat Educ. 2000;8(2):532–41.10.1080/10691898.2000.12131289Search in Google Scholar

[19] McNemar Q. Note on the sampling error of the difference between correlated proportions or percentages. Psychometrika. 1947;12(2):153–7.10.1007/BF02295996Search in Google Scholar PubMed

[20] Firth D. Bias reduction of maximum likelihood estimates. Biometrika. 1993;80(1):27–38.10.1093/biomet/80.1.27Search in Google Scholar

[21] Hudson AL. Where do youth in foster care receive information about preventing unplanned pregnancy and sexually transmitted infections?. J Pediatr Nurs. 2012;27(5):443–50.10.1016/j.pedn.2011.06.003Search in Google Scholar PubMed

[22] Knight A, Chase E, Aggleton P. Teenage pregnancy among young people in and leaving care: Messages and implications for foster care. Adopt Foster. 2006;30(1):58–69.10.1177/030857590603000108Search in Google Scholar

[23] Rubin DM, Alessandrini EA, Feudtner C, Mandell DS, Localio AR, Hadley T. Placement stability and mental health costs for children in foster care. Pediatrics. 2004;113(5):1336–41.10.1542/peds.113.5.1336Search in Google Scholar PubMed

[24] Thrane LE, Chen X. Impact of running away on girls’ pregnancy. J Adolesc. 2012;35(2):443–9.10.1016/j.adolescence.2011.07.011Search in Google Scholar PubMed

[25] Thompson SJ, Bender KA, Lewis CM, Watkins R. Runaway and pregnant: risk factors associated with pregnancy in a national sample of runaway/homeless female adolescents. J Adolesc Health. 2008;43(2):125–32.10.1016/j.jadohealth.2007.12.015Search in Google Scholar PubMed PubMed Central

[26] Winter VR, Brandon-Friedman RA, Ely GE. Sexual health behaviors and outcomes among current and former foster youth: A review of the literature. Child Youth Serv Rev. 2016;64:1–14.10.1016/j.childyouth.2016.02.023Search in Google Scholar

[27] Oshima KM, Narendorf SC, McMillen JC. Pregnancy risk among older youth transitioning out of foster care. Child Youth Serv Rev. 2013;35(10):1760–1765.10.1016/j.childyouth.2013.08.001Search in Google Scholar PubMed PubMed Central

[28] Anderson JE, Santelli J, Gilbert BC. Adolescent dual use of condoms and hormonal contraception: trends and correlates 1991–2001. Sex Trans Dis. 2003;30(9):719–22.10.1097/01.OLQ.0000078628.84288.66Search in Google Scholar PubMed

Received: 2016-12-14
Accepted: 2017-02-21
Published Online: 2017-10-13

©2019 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 26.4.2024 from https://www.degruyter.com/document/doi/10.1515/ijamh-2016-0155/html
Scroll to top button