Given the high reproductive health risks faced by commercially sexually exploited youth (CSEY), we sought to understand their attitudes and beliefs towards contraception and pregnancy.METHODS:
We conducted semi-structured interviews with 21 female CSEY. Participants were recruited through group homes and a juvenile specialty court serving CSEY. Interviews were audio-recorded, transcribed, and coded for emergent themes using in-depth thematic content analysis.RESULTS:
Overall, CSEY report relatively easy access to contraception. The youth intensely valued autonomy and expressed a strong preference for condoms as the primary form of contraception. Most respondents described an aversion towards hormonal birth control, attributed to personal experiences and peer accounts of side effects. Many also shared a common belief that hormonal methods are “unnatural,” cause infertility, and have low efficacy. Coupled with a preference for condom use was the reporting of frequent unprotected sex. Most had an attitude towards pregnancy of “if it happens, it happens.” Those who had been pregnant described confusion related to prenatal care and birthing, as well as frequent visits to the emergency room for pregnancy-related concerns.CONCLUSION:
Given risks associated with their exploitation, to reduce unplanned pregnancy in CSEY, increased utilization of hormonal contraception is a promising option, in addition to reinforcing the importance of consistent condom use. For CSEY, contraceptive education that dispels prevailing myths, sets clear expectations regarding side effects, and emphasizes autonomy is most likely to be effective. Additionally, enhancing education about pregnancy and child-rearing can help CSEY appreciate the significance of their decisions regarding contraceptive use.