Gelberg Lillian, Browner C H, Lejano Elena, Arangua Lisa
Department of Family Medicine, David Geffen School of Medicine at UCLA, 50-071 CHS, Box 951683, Los Angeles, CA 90095-1683, USA.
Women Health. 2004;40(2):87-100. doi: 10.1300/J013v40n02_06.
Homelessness is an escalating national problem and women are disproportionately affected. Nevertheless, few studies have focused on the special circumstances associated with being a homeless woman. For instance, while both genders experience serious barriers to obtaining health care, homeless women face an additional burden by virtue of their sexual and reproductive health needs. The current study was conducted as the first stage of a qualitative/quantitative investigation of homeless women's access and barriers to family planning and women's health care. We interviewed 47 homeless women of diverse ages and ethnic backgrounds. A qualitative approach was initially taken to explore the factors homeless women themselves perceive as barriers to their use of birth control and women's health services, and factors they believe would facilitate their use. Key findings are that health is not a priority for homeless women, that transportation and scheduling can be particularly burdensome for homeless women, and that being homeless leads some to feel stigmatized by health care providers. Despite being homeless, having children was extremely important to the women in our study. At the same time, those interested in contraception confronted significant barriers in their efforts to prevent pregnancies. We conclude with suggested interventions that would make general, gynecological, and reproductive health care more accessible to homeless women.
无家可归是一个日益严重的全国性问题，女性受其影响的程度尤为严重。然而，很少有研究关注与无家可归女性相关的特殊情况。例如，虽然男女在获得医疗保健方面都面临严重障碍，但无家可归女性因其性健康和生殖健康需求而面临额外负担。本研究是对无家可归女性获得计划生育和妇女医疗保健的途径及障碍进行定性/定量调查的第一阶段。我们采访了47名年龄和种族背景各异的无家可归女性。最初采用定性方法来探究无家可归女性自身认为是其使用避孕措施和妇女健康服务的障碍的因素，以及她们认为会促进其使用的因素。主要发现是，健康对无家可归女性来说并非首要任务，交通和日程安排对无家可归女性可能特别繁重，而且无家可归导致一些人感到受到医疗保健提供者的歧视。尽管无家可归，但生育孩子对我们研究中的女性极其重要。与此同时，那些对避孕感兴趣的人在预防怀孕的努力中面临重大障碍。我们最后提出了一些干预建议，以使无家可归女性更容易获得一般医疗、妇科和生殖健康护理。
