Investigating Change in Psychosocial Outcomes for Young Adults Experiencing Homelessness in Los Angeles With and Without Pregnancy Experiences

Abstract

Context: Young adults experiencing homelessness (YAEH) have higher rates of pregnancy than stably housed young adults. Pregnant and parenting YAEH face several challenges, but little is known about outcome change over time.

Methods: 276 YAEH (aged 18-25, 28% female sex at birth) receiving services at drop-in centers in Los Angeles, California, participated in an intervention study to address substance use and sexual health. At each survey, participants reported whether they experienced pregnancy or got someone pregnant in the past 3 months. Regression models examined associations between pregnancy and several outcomes at 24 months (education, employment, income, health, substance use, service use, and housing), controlling for intervention and outcomes at baseline.

Results: Fifty-six participants (20%, n = 26 female sex, n = 30 male sex) reported being pregnant or getting someone pregnant over the course of the study. For women, pregnancy was associated with higher odds of staying in transitional housing (OR = 5.01, 95% CI: 1.22-20.60) and emergency shelters (OR = 8.32, 95% CI: 1.57-44.02) at 24 months, controlling for baseline. For men, getting someone pregnant was associated with greater importance of cutting down alcohol use (b = 2.06, SE = 0.89, p = 0.02) and higher odds of education service use at 24 months (OR = 3.00, 95% CI: 1.16-7.79).

Conclusions: Pregnancy may be associated with greater use of housing services among female YAEH, and increased importance of cutting down alcohol and use of education services among male YAEH. Continued support is needed to improve long-term outcomes of pregnant and parenting YAEH.

Trial registration: ClinicalTrials.gov identifier: NCT03735784. https://clinicaltrials.gov/ct2/show/record/NCT03735784.

Keywords: homelessness; pregnancy; service use; young adults.