Barriers to Long-Acting Reversible Contraceptive Uptake Among Homeless Young Women

Study ObjectiveTo identify barriers to long-acting reversible contraception (LARC) uptake among homeless young women.DesignIn this mixed methods study surveys and guided interviews were used to explore women's contraceptive and reproductive experiences, interactions with the health care system, and their histories of homelessness.SettingAll surveys and interviews were conducted at a homeless drop-in center or shelter.ParticipantsFifteen women between 18 and 24 years of age with a past year history of homelessness.InterventionsNone.Main Outcome MeasuresPerceived barriers to contraceptive use, including knowledge and access barriers and interactions with the health care system around reproductive health.ResultsConfusion about the possibility of early termination of LARC, and the perception that providers deliberately withhold selective information about contraceptive options to bias contraceptive decision-making, were 2 key new findings. Women also reported interest in visual aids accompanying verbal contraceptive counseling. Pregnancy attitudes and history of reproductive and sexual coercion also influenced contraceptive decision-making and reported interest in LARC methods.ConclusionComprehensive counseling about all contraceptive options, including LARC, are important for targeting the perceived gaps in contraceptive education and care among homeless young women.