"Objective: To determine whether biopsychosocial factors are associated with sexual activity and
contraceptive utilization among homeless shelter adolescents.
Methods: A retrospective study of 440 adolescents at a shelter in Pennsylvania between February 2015 and
September 2019 was conducted. The cohort was evaluated to determine what relationship age, gender
identity, substance use, and trauma history have with sexual activity and contraceptive utilization.
Results: Sexual activity was significantly related to age; remote history of self-harm behavior, history of aggressive behavior, history of trauma, and substance use.
Conclusions: Females self-reported sexual activity using contraception more than males. After adjustment,
older age and substance use were associated with sexual activity. By better understanding the impact these
factors can have on contraceptive utilization, informed policy and practice interventions can be developed
and implemented to help increase safe sex practices in spaces where homeless adolescents access
healthcare."