Foster Youth Need Sex Ed, Too: Addressing the Sexual Reproductive Health Needs of Youth in the Child Welfare System

Adolescents placed in our child welfare system are at increased risk for health disparities and poverty upon leaving the system. At present, more than 500,000 American children live in foster care. These young people are at greater risk of sexually transmitted infections, including HIV/AIDS and early pregnancy than other teens. Many teens in foster care become parents, either while they are in the foster care system or shortly after transitioning out of the system. A comprehensive approach to addressing the sexual reproductive health needs of foster youth is necessary. This study examined the impact of a pilot evidence-based intervention implemented within child welfare agencies to address the reproductive needs of this special population.

Participants were child welfare workers and foster parents in an urban area where girls in foster care were three times more likely to give birth between the ages of 15 and 19 than other youth in the state. Child welfare workers and foster parents attended a specialized training led by education and training specialists which engaged participants in: separating their own values around sexuality from their professional role as a resource for youth; discussing the characteristics of healthy and unhealthy relationships and offering resources to youth in unhealthy relationships; understanding the basic affects of trauma, child abuse and neglect on sexual development and utilize strategies to discuss sexuality with youth who have experienced such; and, other issues relevant to foster youth’s sexuality. Surveys designed to measure knowledge, attitudes, and behaviors were administered prior to the training and six months follow-up.

Sixty participants were enrolled– 42 child welfare workers and 18 foster parents. The majority of participants were African American. Foster parents were older; whereas, child welfare workers had significantly higher education and income. The majority of participants believed that negative sexual behavior outcomes, such as STI/HIV/AIDS, unwanted pregnancy, abortion, and sexual assaults were a problem for foster youth. Prior to the training, less than 50% of participants had advised foster youth on reproductive health and contraceptive use in the previous 3 months whereas more than 80% had avoided talking about sex topics with traumatized youth. At follow-up, the number of participants who avoided these discussions had decreased and those who had advised foster youth on reproductive health and contraceptive use had significantly increased.

Foster youth are at an increased risk for pregnancy and sexually transmitted infections due to their increased likelihood to engage in high-risk behaviors. Child welfare workers and foster parents could benefit from direct training in how to engage foster youth about their sexual reproductive health and promote positive sexual reproductive health behaviors.