Youth in foster care or the juvenile justice system have higher rates of pregnancy, sexually transmitted infections, and associated sexual risk behaviors than youth living with their families. Young mothers in foster care have unique needs and challenges, including risk of rapid repeat pregnancies and limited parenting skills. For young men, half of 21-year olds aging out of foster care report having a child compared to 19% of young men who have not been in foster care. Why are youth involved in foster care or the juvenile justice system more at risk? What can we do to support them as they transition to adulthood?
Adverse childhood experiences put children and youth at risk for abuse or maltreatment leading to involvement in the child welfare or juvenile justice systems. All young people experience important developmental milestones on their path to becoming healthy adults. While this time of change is full of promise, it can also be a time of increased vulnerability. For system-involved youth, navigating this time of change can be fraught with even more challenges or barriers. Without strong family and social networks, they may face increased risk of unprotected sex and sex with multiple partners, unintended pregnancy, HIV, and other sexually transmitted infections.
We examined survey data to assess the overall sexual reproductive health behaviors for youth aged 14-21 in out-of-home care in an urban environment (n=270; 60.7% Male; 82% African American; 7.9% Latinx). Over three quarters of these teens reported sexual intercourse at some point in their lifetime. Of these, 86% were sexually active before the age of 16. Compare this with youth in nationally representative samples where only 47% report having ever had sex and 34% of those reported early sexual debut.
Youth in foster care or the juvenile justice system have higher rates of pregnancy, sexually transmitted infections, and associated sexual risk behaviors than youth living with their families.
When asked about their beliefs about condom effectiveness, 38% believed that condoms when used correctly can decrease the risk for pregnancy, HIV, and other sexually transmitted infections “a lot.” Fifty-three percent were unaware that condom use can decrease their risk of getting HIV/AIDS and other STIs. This lack of knowledge was reflected in their low condom use. Only three percent reported using a condom during sex in the last three months.
Thirteen percent reported receiving no sexuality education. Due to frequent foster care placements and unstable living environments, system involved youth are less likely to complete sexuality education programs even when they are offered.
System involvement is a social determinant of health that needs to be considered when providing sexual reproductive health information to youth in out-of-home care. System-involved youth are not only navigating the developmental tasks of adolescence and young adulthood. They are also dealing with the emotional upheaval related to being removed from their biological family. To improve the sexual reproductive health of these youth, it is necessary to create effective research-based prevention strategies. These strategies include training child welfare workers and foster parents on how to communicate with youth about sex.