Chronically homeless women's perceived deterrents to contraception.
BACKGROUND
Despite the growing number of homeless women of reproductive age, little is known about their reproductive health and contraceptive use.


METHODS
A representative sample of 974 currently homeless women surveyed in Los Angeles County in 1997 included 229 who were chronically homeless and at risk for unintended pregnancy. The relationships between perceived deterrents among these women and their frequency of contraceptive use were evaluated using chi-square tests. Logistic regression analyses were performed to identify independent predictors of contraceptive deterrents.


RESULTS
The most commonly cited deterrents to contraceptive use were side effects, fear of potential health risks, partner's dislike of contraception and cost (20-27%). Women who reported substantial deterrents were significantly less likely than others to use contraceptives consistently. Perceived deterrents differed by women's characteristics: Hispanic women were more likely than whites to view not knowing how to use contraceptives or which method to use as a deterrent (odds ratios, 9.6-9.8); black women were more likely than whites to cite not knowing which method to use (4.0), lack of storage (5.5), health risks (6.0) and discomfort (3.3). Women with a history of drug abuse had elevated odds of citing not knowing how to use contraceptives, uncertainty about which method to use and cost as deterrents (5.2-7.7).


CONCLUSIONS
Homeless women report substantial deterrents that reduce their contraceptive use. The multiplicity and heterogeneity of their perceived deterrents suggest a need for reproductive health services that are more integrated and culturally competent than those currently offered.
Gelberg
Lillian
L
Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA), USA. gelberg@ucla.edu
Leake
Barbara
B
Lu
Michael C
MC
Andersen
Ronald
R
Nyamathi
Adeline M
AM
Morgenstern
Hal
H
Browner
Carole
C
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002140:California / Q000453:epidemiology; D003268:Contraception Behavior / Q000523:psychology* / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006703:Ill-Housed Persons / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D017533:Marital Status / Q000706:statistics & numerical data; D016017:Odds Ratio; D011247:Pregnancy; D012044:Regression Analysis; D019966:Substance-Related Disorders / Q000453:epidemiology; D013995:Time