Abstract
Study Objective
Because of the high reproductive health risks that commercially sexually exploited
youth (CSEY) face, we sought to understand facilitators and barriers related to their
use of condoms and hormonal contraception.
Design, Setting, Participants, Interventions, and Main Outcome Measures
We conducted semistructured interviews with 21 female CSEY. Interviews were audio-recorded,
transcribed, and coded for emergent themes. Participants were enrolled through group
homes and a juvenile specialty court serving CSEY.
Results
Overall, CSEY reported relatively easy access to hormonal contraception and condoms,
expressing a strong preference for condoms as their primary form of contraception.
Most respondents described an aversion toward 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.
Although youth expressed a preference for condom use, they also reported frequent
unprotected sex. Furthermore, there were notable barriers to hormonal contraception
and condom use that were specific to youths’ sexual exploitation, primarily because
of their lack of control while trafficked.
Conclusion
Although participants noted relatively easy access to contraception, a number of barriers
to condom and hormonal contraceptive use exist. Many of these barriers align with
youth identified in other at-risk adolescent populations, however, CSEY also face
a number of barriers that might be attributable to their unique experience of commercial
sexual exploitation. Contraceptive education that dispels prevailing myths, sets clear
expectations regarding side effects, and emphasizes autonomy is most likely to resonate
with their world view and experiences.
Key Words
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Article info
Publication history
Published online: December 07, 2018
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
