Youths experiencing homelessness (YEH) become pregnant at five times the general population rate. Education, social, and health care systems struggle to adequately address this young community’s sexual and reproductive health needs, yet social workers are well positioned across sectors to address their sexual and reproductive health and well-being. A growing body of literature exists on the factors affecting YEH’s access and selection of birth control, prompting the present review that aimed to understand this process and inform better attuned sexual and reproductive health approaches. Using a systematic search and analytic approach, we retrieved 203 articles, of which 23 met inclusion criteria. Key findings emerged across socioecological levels, including barriers and facilitators to condom use; the differential impact on YEH of hormonal birth control side effects; and the devastating effects of economic insecurity leading to sexual exploitation, survival sex, and exposure to violence. Implications include the need for multilevel intervention that addresses youths’ knowledge, attitudes, and behavior as well the need to improve social norms and system design to provide better attuned care for YEH.

中文翻译：

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美国无家可归青年的节育使用和选择：回顾

经历无家可归（YEH）的青年怀孕率是一般人口的五倍。教育、社会和卫生保健系统努力充分满足这个年轻社区的性和生殖健康需求，但社会工作者在各个部门都处于有利地位，以解决他们的性和生殖健康和福祉。关于影响 YEH 获得和选择节育措施的因素的文献越来越多，促使本次审查旨在了解这一过程并为更好的性健康和生殖健康方法提供信息。使用系统搜索和分析方法，我们检索了 203 篇文章，其中 23 篇符合纳入标准。社会生态层面出现了主要发现，包括使用安全套的障碍和促进因素；激素避孕副作用对 YEH 的不同影响；以及经济不安全导致性剥削、生存性行为和遭受暴力的破坏性影响。其影响包括需要针对青少年的知识、态度和行为进行多层次干预，以及需要改善社会规范和系统设计，以便为 YEH 提供更好的护理。