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

Study Objective: To identify barriers to long-acting reversible contraception (LARC) uptake among homeless young women. Design: In 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. Setting: All surveys and interviews were conducted at a homeless drop-in center or shelter. Participants: Fifteen women between 18 and 24 years of age with a past year history of homelessness. Interventions: None. Main Outcome Measures: Perceived barriers to contraceptive use, including knowledge and access barriers and interactions with the health care system around reproductive health. Results: Confusion 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. Conclusion: Comprehensive counseling about all contraceptive options, including LARC, are important for targeting the perceived gaps in contraceptive education and care among homeless young women.