Perceived barriers and facilitators to accessing/utilising sexual and reproductive healthcare for people experiencing homelessness:A systematic review
PHE ePoster Library. Paisi M. Sep 12, 2019; 274503; 62
Dr. Martha Paisi
Dr. Martha Paisi
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Abstract
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Abstract Introduction
People who experience homelessness face disproportionately poor reproductive health and adverse pregnancy outcomes. They are also at an increased risk of sexually transmitted infections. However, the uptake of sexual and reproductive healthcare and their engagement with services is not consistent. The aim of the systematic review was to identify the perceived barriers and facilitators to accessing/utilising sexual and reproductive healthcare for people experiencing homelessness.
Method
Electronic databases (EMBASE, MEDLINE, CINAHL, SOCINDEX) and on-line sources (Google, ETHOS, Open Grey, the Health Foundation, Social Care online and the Faculty of Sexual and Reproductive Health) were searched. Two reviewers independently carried out the screening, data extraction, critical appraisal and synthesis. Thematic analysis was used to synthesise the qualitative findings.
Results
Following deduplication and screening 16 papers/reports met the eligibility criteria and were included in the review. Five themes were generated, which were subsequently grouped into two main domains. The latter included the lived experience of homelessness (Complexity, Emotions, Knowledge) and the care system (Staff encounter, Accessibility/Organisational).
Conclusion
The lived experience of homelessness and structure and design of care system are significant barriers for people who experience homelessness in utilising and accessing sexual and reproductive healthcare. Robust evidence-based interventions that increase homeless peoples' access to long term contraceptive methods and pregnancy prevention and family planning programs, particularly among homeless youth, are needed. The systematic review highlights current gaps in the literature and provides recommendations for enhancing future research and practice in accordance with meeting the needs of this vulnerable group in the community. External funding details Not applicable
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