Women who spent any time living in foster homes or with relatives other than their parents during childhood have an elevated risk of engaging in high-risk sexual behaviors, according to an analysis of data from the 1995 National Survey of Family Growth (NSFG).1 They are nearly a year younger than other women when they first become pregnant, and they have elevated odds of having more than three sexual partners over their lifetime. Those who lived with relatives also begin having intercourse at a younger age than women who always lived with at least one biological parent. More than 500,000 children are placed in living arrangements outside their parents' home each year; the analysts note, however, that the extent to which this experience influences their sexual behavior has received little attention.

The nationally representative NSFG data permitted researchers to examine patterns of sexual behavior among three groups of women: 89 who had ever lived in foster care, 513 who had ever lived in kinship care (that is, with relatives other than their parents) and 9,018 who had always lived with at least one parent (the comparison group). Women were excluded if they had never lived with their biological parents, they were foreign-born or they had lived in a group home at any point in their childhood.

In all three groups, the women's average age was 30-32 years, and non-Hispanic white women were the predominant racial group; black women represented a greater proportion of the kinship group (30%) than of the foster care and comparison groups (12-13%). Women who had always lived with their parents had more schooling (12.9 years, on average) than those who had ever had other living arrangements (11.9-12.2).

Bivariate analyses revealed no significant differences between the foster care and the kinship care groups with respect to factors related to sexual behavior and risk, but both of these groups differed from the comparison group in a number of ways: They were significantly more likely to have had an unwanted sexual experience before they were 18 years old (13-18% vs. 8%), to have been born to a single woman (17-21% vs. 5%) and to have had more than three partners (74-75% vs. 63%). These women also had been younger when they first had voluntary intercourse (16.4-16.8 years, on average, compared with 17.4 years) and when they first conceived (19.1-19.2 vs. 21.0 years).

Using multiple linear and logistic regression analyses, the researchers assessed the independent effects of childhood living arrangements on sexual behavior, controlling for background and risk-related factors. The first set of calculations showed that women in the kinship care group were six months younger than those in the comparison group when they first had voluntary intercourse; women who had lived in a foster family, however, did not differ from the comparison group on this measure. In the second set of multivariate analyses, the investigators found that compared with women who had always lived with their parents, those who had spent time in foster homes first became pregnant 11.3 months earlier, and those who had lived in the care of relatives first conceived 8.6 months earlier. Finally, both groups who had lived outside their parents' home had significantly increased odds of having had more than three sexual partners (odds ratios, 1.4-1.7).

In commenting on their findings, the researchers emphasize that the results "cannot implicate placement into foster and kinship care as the direct cause of...high-risk behaviors." Nevertheless, they conclude that the results have important clinical ramifications. Most important, in their view, children's and adults' health care providers should be aware of the sexual risks faced by female patients who live or have lived outside their parents' home. Additionally, youngsters and young adults who have lived in foster or kinship care may benefit from services involving collaboration between health care, education and child welfare professionals. And since reliance on kinship care is on the rise, it is important to recognize that such care "may not be more protective than traditional foster care with regard to long-term sexual and reproductive behaviors." --D. Hollander


1. Carpenter SC et al., The association of foster care or kinship care with adolescent sexual behavior and first pregnancy, Pediatrics, <http://www.pediatrics.org/cgi/ content/full/108/3/e46>.