Structural Resilience and Contraceptive Self-Efficacy Among Formerly Incarcerated Women

Abstract

Introduction: Incarcerated women often have a history of physical or sexual violence, with the majority experiencing this violence before entering the criminal justice system. The trauma these women endure is treated as a criminal issue rather than a public health crisis. This study investigates the impact of structural resilience factors (housing, insurance, employment) on contraceptive self-efficacy. Understanding the relationship can inform policies to help rebuild resilience and knowledge of reproductive health. Methods: This study analyzed data from the Sexual Health Empowerment ((S)HE) Women Annual Survey (2020-2021), a longitudinal study focused on improving health literacy and resources for previously incarcerated women in Kansas. Guided by Relational Cultural Theory, we examined how structural resilience factors such as housing stability, employment status, and health insurance relate to contraceptive self-efficacy. Participants (n = 229) were recruited using respondent-driven and passive sampling methods. We tested whether resilience mediates contraceptive self-efficacy and examined the history of violence through categorical analyses and cross-tabulations. Results: Employment showed a weak but statistically significant positive correlation with contraceptive self-efficacy (r = 0.148, p = 0.0406). Insurance, housing, and history of violence showed no significant associations. Conclusion: Incarcerated women are a marginalized population within public health research. This study highlights the need for further research to understand the relationship between structural resilience factors and contraceptive self-efficacy. There is an urgent need for policies or programs to help incarcerated women heal and rebuild.