Objective To examine the prevalence of and factors associated with sexual behavior and pregnancy involvement among adolescents in foster family homes. Methods A cross-sectional study was conducted among a random sample of children living in foster family homes. Logistic regression with Firth's correction was used to determine factors associated with sexual risk behavior and pregnancy involvement (i.e. having been pregnant or gotten someone pregnant). Results About half of adolescents (aged 13-18 years) in foster family homes ever had sex, of whom, one third had first sex before the age of 14 and one sixth had two or more sexual partners in the past 3 months. Of adolescents in the study, 9% had ever been pregnant or gotten someone pregnant. Although adolescents in foster family homes had higher rates of sex initiation and pregnancy involvement than those in the general population, the two groups had comparable rates of current sexual risk behavior. Being placed in kin/fictive kin foster homes [odds ratio (OR): 3.04; 95% confidence interval (CI): 1.18-7.80] and number of placement settings (OR: 1.20; 95% CI: 1.02-1.42) were associated with multiple sexual partners, while a history of running away from a foster home (OR: 7.64; 95% CI: 1.87-31.18) was associated with pregnancy involvement. Conclusions Efforts targeting placement stability including prevention of running away may reduce sexual risk behavior and pregnancy involvement among adolescents in foster family homes.
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