The authors conducted an assessment to describe the prevalence of and risk factors associated with lifetime pregnancy involvement (LPI) among street youth from three Ukrainian cities. They used modified time-location sampling to conduct a cross-sectional assessment in Odesa, Kyiv, and Donetsk that included citywide mapping of 91 public locations frequented by street youth, random selection of 74 sites, and interviewing of all eligible and consenting street youth ages 15-24 years found at sampled sites (n = 929). Characteristics of youth and prevalence of LPI overall and by demographic, social, sexual, and substance use risk factors, were estimated separately for males and females. Adjusted odds ratios (AORs) were calculated with multivariable logistic regression and effect modification by gender was examined. Most (96.6%) eligible youth consented to participate. LPI was reported for 41.7% of females (93/223) and 23.5% of males (166/706). For females, LPI was significantly elevated and highest (70%) among those initiating sexual activity at less than or equal to 12 years and for those reporting lifetime anal sex and exchanging sex for goods. For males, LPI was significantly elevated and highest (40%) among those who reported lifetime anal sex and history of a sexually transmitted infection. Overall, risk factors associated with LPI were similar for females and males. Among the total sample (females and males combined), significant independent risk factors with AORs greater than or equal to 2.5 included female gender, being aged 20-24 years, having five to six total adverse childhood experiences, initiating sex at age less than or equal to 13-14 years, lifetime anal sex, most recent sex act unprotected, and lifetime exchange of sex for goods. Among street youth with LPI (n = 259), the most recent LPI event was reported to be unintended by 63.3% and to have ended in abortion by 43.2%. The authors discuss preventive strategies that are likely applicable to other urban populations of street-based youth as well.
Journal of Urban Health, 88 (4)
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