by Elizabeth Barnert, Ava Sun, Laura Abram, and Paul J Chung
Rates of sexually transmitted infections (STIs) among incarcerated youth are 10 times higher than the general adolescent population. One-third of incarcerated girls in the United States report having been pregnant. Clearly young people who have contact with the juvenile justice system are in great need of reproductive health services.
When youth leave a secure facility, they remain at high risk for STIs and unintended pregnancies. Despite these high needs and the potential “window” to reach youth when they re-enter the community, the intersection between youths’ reproductive health needs and reentry is underexplored. To address this gap, we conducted a systematic literature review to describe what is known about youths’ reproductive health needs during community reentry.
To conduct the review, we searched PubMed, CINAHL, Cochrane Library, and Google Scholar for articles containing key words with the concepts “child or adolescent,” “incarcerated,” and “reentry.” In the search, we defined the concept of “reentry” as within 1 month prior to release (to include interventions involving pre-release planning) and up to 18 months after release from incarceration.
We only found 14 peer-reviewed articles on youths’ reproductive health post-incarceration
In combing the literature, we identified only 14 peer-reviewed articles on youths’ reproductive health during reentry. Overall, given the breadth of the search, the available literature was extremely limited. Studies varied in methods and quality, and all 14 of the studies were conducted in the US. We found that the limited available research on youths’ reproductive health during reentry focuses on frequency of sexual risk behaviors, such as lack of condom use, as well as prevalence of STIs. The studies indeed indicate that reentry is a time when youth could benefit from reproductive health outreach and interventions. Additionally, existing intervention studies are few, but promising. More intervention studies to guide programmatic development and implementation should be prioritized.
Gender-specific interventions can improve the reproductive health outcomes for young men and women who have been incarcerated
The qualitative studies in the extant literature provide a useful exploration of youths’ perspectives on reproductive health education and gender-specific concerns related to reproductive health needs. In short, findings from the review suggest that gender-specific interventions are important for both males and females, and that strong opportunities exist to improve the reproductive health outcomes for young people who have been incarcerated.
Overall, the small number of articles identified in our cross-disciplinary search is perhaps the clearest evidence that the reproductive health status and needs of these high risk youth remain under the public health radar. Barriers to research involving justice-involved youth are multi-factorial: federal funding for research on the health of justice-involved populations is often disproportionately limited, bureaucratic hurdles such as institutional review boards and agency approvals can be challenging to surmount, and youth may be difficult to track during the reentry period.
More research from outside the US is needed
However, the available data suggests that research in this area is worthwhile. In particular, attention from researchers outside the US is needed. Practitioners, policymakers, and researchers worldwide can feel encouraged by the positive reproductive health outcomes demonstrated in the reentry intervention studies and can enhance focus in this area. Dedication to this marginalized youth population has the potential to improve youths’ health as they transition into adulthood, which can narrow the growing racial/ethnic and socioeconomic health disparities in our society.