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Article

Economic Vulnerability and Associated Sexual Risk Factors for Adolescent Pregnancy Among Adolescent Females in Southern California

by
Mia Mora
1,*,
Guadalupe X. Ayala
2,
Emily Schmied
2,
Ning Tang
3 and
Elizabeth Reed
1
1
School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA
2
School of Public Health, Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA 92123, USA
3
Fowler College of Business, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA
*
Author to whom correspondence should be addressed.
Adolescents 2025, 5(3), 35; https://doi.org/10.3390/adolescents5030035
Submission received: 16 April 2025 / Revised: 19 June 2025 / Accepted: 3 July 2025 / Published: 11 July 2025
Review Reports Versions Notes

Abstract

We assessed economic vulnerability, measured by food insecurity, in relation to primary risk behaviors for adolescent pregnancy among U.S. adolescent females. The survey data for this cross-sectional study were collected from adolescent females (n = 187) recruited from high schools (n = 18) serving low-income communities in Southern California between January 2022 and July 2023. We used crude and adjusted logistic regression models to assess associations between food insecurity and sexual risk behaviors for adolescent pregnancy (e.g., early age of sexual initiation, contraceptive use, condom use), as well as financial dependence on a male partner. Adjusted models included demographics significantly associated with outcome variables. Participants were, on average, 17 years old (SD = 1.48); most participants were born in the U.S. (90.3%) and identified as Latina/Hispanic (85.0%). In crude and adjusted bivariate logistic regression models, compared to participants not reporting food insecurity, participants who reported food insecurity were (1) more likely to report early age at first sex (aOR: 3.6, 95% CI: 1.1–11.7), (2) less likely to report condom use in the previous six months among those sexually active during that timeframe (aOR = 0.2, 95% CI: 0.1–0.6), and (3) more likely to report being financially dependent on a male partner (aOR: 4.2. 95% CI: 1.6–11.3). The findings suggest the importance of addressing economic vulnerability to reduce risk factors for adolescent pregnancy.

1. Introduction

Adolescent pregnancy rates in the United States (U.S.) are remarkably higher compared to other high-income countries [1] and are associated with increased adverse perinatal outcomes and maternal and neonatal mortality compared to adult pregnancy [2,3]. Adolescent pregnancy is also a barrier to educational and economic opportunities among adolescent mothers [4]. Adolescent mothers are two and a half times more likely to have a low English language proficiency and a low literacy level compared with similarly aged adolescents who are not mothers [1]. Only 50% of adolescent mothers will receive their high school diploma before the age of 22, compared to 90% of adolescents who do not give birth [5].
Adolescent pregnancy disproportionately affects certain subgroups of adolescent girls in the U.S. Despite a decrease in teen births within the U.S. since 2009 across all racial/ethnic groups, Latina adolescents maintain a higher teen birth rate (23.5 births per 1000) compared to white adolescents (10.4 births per 1000) [6]. Disparities in adolescent pregnancy rates among Latina adolescents vary by geographic region in the U.S. as well. Among Latina adolescents in the U.S., 57% of births at adolescence occur within the U.S.–Mexico border region [7], for instance, along the U.S.–Mexico border in Southern California, where 43.3% of the child population are Hispanic/Latino adolescents [8]. Latina adolescents accounted for roughly 75% of adolescent births in the region in 2016 [9].
Disparities in sexual risk behaviors and contraceptive use contribute to the disproportionate rates of adolescent pregnancy and childbirth across race and ethnicity. Sexual risk behaviors for adolescent pregnancy may include an early age of initiation of sexual activities, vaginal or anal sex without a condom, and multiple sexual partners [10]. Latino adolescents are twice as likely to engage in sexual intercourse before age 13 compared to non-Latino white adolescents and are more likely to initiate sexual intercourse before the age of 17 than both Black and non-Latino white peers [11]. In addition, they are less likely to report condom use, elevating their risk of STIs and unintended pregnancy [12].
Past intervention studies focusing on adolescent pregnancy and reducing sexual risk behaviors among Latina adolescents have largely focused on gender-derived cultural norms [4,13] and the influence of acculturation [10,12,14], which impact sexual decision-making control and pregnancy intentions. While it is imperative to address these social influences, emerging research has suggested the need to also examine economic factors in understanding reproductive and sexual health risks associated with adolescent pregnancy among Latina adolescents [15,16], particularly among Latina youth residing in low-income and/or immigrant communities with less access to healthcare, health education, and other related resources [12,16,17,18]. Among U.S. adolescents, there are significant socioeconomic disparities in adolescent pregnancy, childbearing, and STIs [18]. There is a significant positive correlation between socioeconomic vulnerability and teen birth rates across the U.S. [19]. High teenage pregnancy rates occur in highly dense poverty areas, with at least 48% of teen mothers living below the poverty line and even higher rates in minoritized ethnic communities [15,20]. Furthermore, among adolescent girls, studies have found that economic vulnerability may reduce future expectations related to educational/career opportunities and, in turn, deprioritize delaying pregnancy [16,18,21]. Notably, Latina adolescents living in low-income communities along the U.S.–Mexico border often experience compounding economic risks, including high rates of poverty, limited access to formal employment, housing instability, and reduced access to health and educational services, all of which may contribute to the disproportionately high rates of adolescent pregnancy reported in this region [7,8,9].
One indicator of economic vulnerability among youth in their home environment is food insecurity [15], defined as limited access to or uncertainty in accessing safe and nutritionally adequate foods [22]; it affects 17 million households in the U.S. [23]. Notably, Latino youth are more likely to report experiencing economic hardship and instances of food insecurity compared to white youth and other peers from non-Latino households [24,25]. Research has shown that economic vulnerability, including food insecurity, creates emotional stress, obligations to sacrifice necessities, and can promote many youth to seek economic support and reliance outside their household [24]. Among adolescents, food insecurity has been found to be an accurate and reliable measure for economic vulnerability [15]. Traditional measures such as income or educational attainment are often inappropriate in this age group, as adolescents typically do not earn a stable income and are still in school. Additionally, they may not have full awareness of broader household economic conditions, such as difficulty paying rent or utilities, nor are they likely to be involved in financial decision making. However, food insecurity reflects the consequences of economic hardship that adolescents directly experience and understand, making it a meaningful proxy for measuring economic vulnerability in this population.
Previous research has illuminated an association between economic vulnerability, including food insecurity, and heightened sexual risk behaviors, leading to STIs and HIV among the general adult population, with few focusing on younger adults and adolescents [26,27]. For example, among adult women, economic vulnerability has been associated with women’s financial dependence on male relationship partners and, in turn, reduced reproductive decision-making control (e.g., decisions to use a condom or contraception) in these relationships [28]. Among adolescents, economic vulnerability and its association with sexual risk behaviors remain largely understudied, despite their recognition among adults as a strong contributing factor to adverse reproductive and sexual outcomes. Preliminary qualitative research among adolescents has suggested that food insecurity, as an indicator of economic vulnerability, promotes adolescent girls’ financial dependence on male partners instead of their families for basic needs, including food [15]. However, little is known about how economic factors, including food insecurity, are associated with sexual and reproductive behavioral risks, including financial reliance on male partners, that contribute to adolescent pregnancy among adolescent girls.
This study assessed economic vulnerability, as measured by food insecurity, and its relation to sexual risk behaviors for adolescent pregnancy, including financial reliance on male partners, among predominantly U.S. Latina adolescent girls recruited from high schools in low-income communities by the US–Mexico border in Southern California. Given the disproportionately high rates of adolescent pregnancy among Latinas and the unique structural and economic risks concentrated in the U.S.–Mexico border region, focused research in this setting is both timely and critical. Findings will fill gaps in the literature on the role of economic vulnerability in relation to sexual risks for adolescent pregnancy.

2. Materials and Methods

The data used for this cross-sectional study were collected as part of a larger, two-armed, randomized-controlled trial evaluating an economic intervention called Girls Invest. Data from the baseline survey were accessed for the current study. All participant data were collected between January 2022 and July 2023. Participants (n = 244) were girls ages 15–22 recruited from 16 local high schools, the majority being alternative charter high schools, and 2 community colleges that primarily serve low-income communities in Southern California. Notably, participating alternative charter schools were those that offer flexible, self-paced learning with teacher support. As a result, students in our sample tended to be older than those in traditional high schools. Participants with missing data on the major variables of interest (e.g., ever having sex) were removed for the current study, resulting in a final study sample of N = 187 participants.

2.1. Study Procedures

At each site, research staff presented an initial information session describing the Girls Invest program and the associated research study. To recruit individuals to attend the information session, fliers were distributed at each site highlighting details of the Girls Invest program and study, as well as details on the information session day and time. Information sessions took place either in person or via Zoom and were facilitated by research study staff; they lasted approximately 30 min. Following the presentations, research staff assisted with questions and enrollment in the study. Girls who met the inclusion criteria (between 15 and 22 years of age who were students in local San Diego County schools) and were interested in the program downloaded the Girls Invest app and completed consent forms digitally. Participants under the age of 18 provided assent along with parental consent. Parental consent was obtained using a hard copy or digitally via the Girls Invest app; consent forms for parents were available in Spanish and English. Interested girls were informed that their participation would not affect their class grades and were informed of all the risks and benefits of participating. Regardless of participation, all girls were provided with a list of resources for relevant local health, social, and economic programs. All signed consent forms were stored separately from survey data.
After consent was obtained, participants completed the baseline survey, which was self-administered online and took approximately 60 min to complete. Participants were encouraged to complete it in a safe and private location. Research staff assisted those who needed help with the survey. Each participant received one USD 25 Amazon e-card after completing the baseline survey. All procedures and measures were reviewed and approved by the San Diego State University Human Research Protection Program.

2.2. Measures

2.2.1. Demographics

Demographic variables, such as age (15–17, 18–20, or 21–22 years old), ethnicity (e.g., identifying as Hispanic/Latina or not), race (e.g., American Indian or Native, Asian, Black or African American, Native Hawaiian/Pacific Islander, White, Multiracial, Other), and whether they were born in the United States (yes/no), were noted to characterize the population. Demographic data also included the participants’ employment status (employed/unemployed) and the participants’ relationship status (in a relationship, dating or going out with someone, hooking up, or single). Living situation (e.g., living with both parents, living with mother, other) was also assessed. Notably, most of the participants in the “other” category reported living with other family; a few reported living with relationship partners (2%) and, thus, were combined into the “other” category.

2.2.2. Food Insecurity

Food insecurity was measured using three items about the participants’ food access in the home during the last month. Questions were adapted from a widely used and validated tool, the United States Department of Agriculture (USDA) Survey, to assess Household Food Security [29,30]. The following questions were asked: (1) How often did you feel like you have enough food to eat, either at home or to purchase out? (2) How often did you feel hungry during the day but did not have any food to eat or money to buy food? (3) How often did you eat at a friend’s house because you did not have food at home? Participants responded to the questions on a 3-point Likert scale: 2 (a lot), 1 (sometimes), 0 (never). Food-insecure conditions were indicated by ‘A lot’ or ‘Sometimes’ responses to questions 2 and 3. Question 1 was reverse coded for analysis; ‘Never’ and ‘Sometimes’ were coded as affirmative to indicate food insecurity. One food insecurity score was created by summing responses to the three questions [31]. Participants were classified as food secure if they reported no food-insecure conditions or as food insecure if they reported one or more conditions of food insecurity (i.e., responded “A lot” or “Sometimes”) [23,32].

2.2.3. Sexual Risk Behaviors for Adolescent Pregnancy

Five sexual risk behaviors were assessed: sexual activity, age of sexual activity initiation, number of sexual partners, condom use, and contraceptive use. Survey questions did not come from existing or validated scales; instead, the investigators developed items to assess risk behaviors known to be related to poor health outcomes among adolescents. Participants were asked, ‘Have you ever had vaginal or anal sex with a boy/man?’ (yes/no). The following question was, ‘How old were you the first time you had sex with a boy/man?’, in which participants were prompted to enter a numeric value. Participants were placed into one of two categories representing participants’ early sexual initiation based on report of sexual initiation before the age of 15 (yes/no); prior research indicates that sexual initiation under the age of 15 is linked to adverse health outcomes [14,33,34].
Participants were prompted to report how many boys/men they had vaginal or anal sex with within their lifetime with a numerical value. The data displayed that 35.4% reported having one or more partners, and 17.4% reported having two or more partners. Given the distribution, the focus was placed on having two or more partners as the higher-risk group. Consequently, responses were recoded to indicate having more than two-lifetime sexual partners (yes/no).
Condom use during the last time they had sex in the past 6 months was assessed among participants reporting having had sex in the last 6 months. Participants were asked, ‘When you had sex in the past 6 months, during the last time you had vaginal or anal sex, did you use a condom?’ (yes/no).
Similarly, contraceptive methods to prevent pregnancy in the past 6 months were assessed among participants reporting having sex in the last 6 months. Participants were asked to report all methods used, including birth control pills, injectable birth control, patch, vaginal ring, IUD, implant, or morning-after pill (yes/no for each item).

2.2.4. Financial Dependence on a Male Partner, Including Depending on Male Partners for Transportation

To assess financial dependence on a male partner, participants were first asked to report, ‘Who buys you the things that you need, such as: food, clothing, school supplies, etc.?’ The response options included: parents/guardians, self, boyfriend, other family members, or other. Participants were coded as ‘yes’ if they reported a boyfriend provided them with necessities or ‘no’ if a boyfriend did not. Participants were then asked, ‘Does a boyfriend or other male partner buy or give you things that you can’t buy on your own?’ (yes/no). A dichotomous variable was created to indicate financial dependence on a male partner, where participants who reported ‘yes’ to either question were classified as financially reliant, and those who responded ‘no’ to both questions were categorized as not financially dependent.
Dependence on a male partner for transportation was assessed by asking participants, ‘Does a boyfriend or other male partner (someone you are going out with, hooking up with, or messing around with) give you a ride to places? For example, he takes you to your friend’s house, the mall, work, or school?’ (yes/no) and ‘If your boyfriend or other male partner did not give you a ride, would you have a hard time finding a ride?’ (yes/no). A dichotomous variable was created to indicate dependence on a male partner for transportation; participants who responded ‘no’ to both questions were classified as not dependent on male partners for transportation; all others were classified as transportation dependent.

2.3. Data Analyses

Descriptive analyses were computed for demographic characteristics, reported food insecurity, dependence on a male partner, and sexual risk behaviors, including means, standard deviations, and frequencies. Chi-square analyses were used to examine the relationship between demographic variables and reported food insecurity, in addition to dependence on a male partner (financial and for transportation), and each of the sexual risk behaviors (having ever had vaginal or anal sex with a boy/man, early age of sexual initiation, number of sexual partners in their lifetime, having had sex in the past six months, condom use and contraceptive use in the past six months). Crude and adjusted logistic regression models were used to examine the association between food insecurity, financial and transportation dependence on a male partner, and each sexual risk behavior. Demographic variables that were associated (p < 0.05) with any of the outcomes (dependence on a male partner and sexual risk behaviors) in bivariate/crude models were included in the adjusted logistic regression models. To ensure model adequacy, we conducted standard diagnostic procedures (including assessment of multicollinearity among covariates), which indicated acceptable model specification. Findings were presented as odds ratio (OR) and adjusted odds ratio (aOR) with 95% confidence intervals (CI). Data analyses were conducted using Statistical Package for the Social Sciences (SPSS) version 29.0.2.0.

3. Results

3.1. Demographic Characteristics and Food Insecurity

Table 1 presents the sample characteristics by whether participants reported food insecurity in the past month. The average age of the sample was 16.8 years old (SD = 1.48); most participants were born in the U.S. (90.3%) and identified as Latina/Hispanic (85.0%). Additionally, most participants reported living with at least one parent (77.0%), not working currently (73.3%), and not in a relationship (49.2%).
Of the 187 participants (ages 15–22), 48.1% reported food insecurity. The only statistically significant differences in reported food insecurity by demographic variables were age and living situation. Most (62%) participants ages 18–22 reported food insecurity, suggesting older participants were more likely to report food insecurity than participants aged 15–17 (x2 = 5.26, p = 0.022). Those living with both parents were less likely to report food insecurity compared to participants reporting another living situation (e.g., living with one parent, a foster or social services home) (x2 = 4.19, p = 0.041).

3.2. Sexual Risk Behaviors and Male Partner Dependence

Table 2 shows that fewer than half of the participants (n = 72; 38.5%) reported having ever had vaginal or anal sex with a boy/man. Only 16.6% of participants reported having vaginal or anal sex with two or more boys/men, whereas 78.6% reported one or zero. The mean number of sexual partners in their lifetime was 0.91 (SD = 1.91). Most participants who have had sex initiated at the age of 15 or older (63.2%). Only 33.6% of the sample, or 63 out of 187 participants, have had sex in the past six months, and 49.2% of those 65 participants indicated using a condom during the last time they had sex in the past six months, whereas 50.8% reported not using a condom. Of the 63 participants who reported having sex in the past six months, 57.1% reported using a contraceptive method.
Nearly a third of participants (25.7%) reported depending on a male partner for transportation, whereas 65.8% did not (Table 2). Additionally, 19.3% of participants reported financial dependence on male partners, whereas 77.0% did not (Table 2).

3.3. Food Insecurity and Association with Sexual Risk Behaviors and Dependence on a Male Partner: Crude and Adjusted Logistic Regression Findings

Compared to those who reported food security, participants who reported food insecurity had higher odds of ever having vaginal or anal sex with a boy/man (OR = 2.0, 95% CI: 1.07–3.6; p = 0.027), early age of sexual initiation (OR = 3.0, 95% CI: 1.0–9.0; p = 0.05), and having sex in the past six months (OR = 1.9, 95% CI: 1.1–3.6; p = 0.034). In addition, reported food insecurity and condom use during the last time they had sex in the past six months were statistically related, such that those who reported food insecurity were less likely to use a condom during the last time they had sex (OR = 0.2, 95% CI: 0.1–0.6; p = 0.003). There was no statistically significant association between reported food insecurity and the number of sexual partners in a lifetime (OR = 1.8, 95% CI: 0.8–3.8; p = 0.16) or contraceptive use in the past six months (OR = 1.0, 95% CI: 0.4–2.7; p = 0.94). There was a statistically significant association between food insecurity and financial dependence on a male partner (OR = 5.0, 95% CI: 2.1–11.8; p ≤ 0.001) and dependence on a male partner for transportation (OR = 2.0, 95% CI: 1.0–3.9; p = 0.047).
When adjusting for identifying as Latina or Hispanic as a covariate in the logistic regression model, reported food insecurity and early age of sex initiation were statistically associated (aOR = 3.6, 95% CI: 1.1–11.7; p = 0.035). Among a subsample of those who have had sex in the past six months and after adjusting for age, participants who reported food insecurity were less likely to use a condom during the last time they had sex (aOR = 0.2, 95% CI: 0.1–0.6; p = 0.004). After adjusting for employment and current relationship status, those who reported food insecurity had higher odds of reporting financial dependence on a male partner (aOR = 4.2. 95% CI: 1.6–11.3; p = 0.004). The association between food insecurity and other sexual risk behavior outcomes (ever having vaginal or anal sex, having sex in the past six months, and contraceptive use in the past six months) and dependence on a male partner for transportation were not significant in adjusted models. However, these behaviors were still of borderline significance (p values approximately at 0.1) (Table 2).

4. Discussion

The present study documented the association between food insecurity, an indicator of economic vulnerability, with several, though not all, studied sexual risk behaviors for adolescent pregnancy among U.S. Latina adolescents residing within the U.S.–Mexico border region in Southern California. Among these sexual risk behaviors were early age of sexual initiation and condom non-use. Notably, the study findings also document an association between food insecurity and financial dependence on a male partner. While previous studies have investigated food insecurity in relation to sexual risk behaviors among the general adult population, there is a paucity of research conducted among adolescents. Our study is among the first studies to explore the connection between food insecurity and sexual risk behaviors for adolescent pregnancy. This study was conducted among a sample of adolescents from schools predominantly serving Latinx communities and where adolescent pregnancy was occurring in high proportions. Notably, nearly half of the study sample (48.1%) reported experiencing food insecurity in the past month. In addition, most (62%) participants aged 18–22 reported food insecurity, suggesting that this period of transition into adulthood may be particularly important to consider in terms of experiences of economic vulnerability and associated poor health outcomes.
Our findings build upon prior studies examining economic vulnerability, including food insecurity, and adverse sexual health outcomes in the U.S. and globally [27]. Our findings are well aligned with previous studies documenting the relation between economic vulnerability, including food insecurity, and sexual risk behaviors (e.g., STI/HIV, multiple sex partners, transactional sex) among adults across diverse populations (e.g., low-income people living with HIV/AIDS, homeless HIV-infected individuals) [27,35,36]. Further, multiple studies conducted among women across the globe have also found an association between food insecurity and reduced control in sexual relationships with male partners, including reduced condom or contraceptive use negotiating power, resulting in adverse sexual health outcomes, including unintended pregnancy [37]. Notably, this previous research has included women in various types of relationships, including married women. While our sample of adolescents were mostly not living with relationship partners and most relationships reported were dating and informal relationships, future research is needed to better characterize the types of relationships girls have with males who are providing them with financial support (e.g., dating or more informal relationships).
Our findings are well aligned with the few existing studies conducted among adolescents that have also found an association between food insecurity, or economic vulnerability more generally, and sexual risk behaviors for adolescent pregnancy. One quantitative study among sexually active females and males also documented a link between reported food insecurity and STI risk factors in the U.S., including non-condom use at the last vaginal or anal sex [26]; however, this study included both adolescents and adults between the ages of 15 and 44 and, thus, was not exclusive to adolescents. Most previous research focusing on adolescents specifically has been qualitative and has suggested that food insecurity, as an indicator of economic vulnerability, may increase financial dependence on male partners for essential needs and, in turn, decrease girls’ reproductive and sexual decision-making power in these relationships [15,16,28]. Our findings suggest that food insecurity is associated with financial dependence on a male partner. More research is needed to further document the quantitative association between food insecurity and sexual risk factors for adolescent pregnancy, as well as to better understand financial dependence on a male partner as an underlying mechanism involved. Future studies may also assess other types of dependence on male partnerships, including for transportation, given that this was of borderline significance in our study, with a small sample of participants reporting relationships. In totality, the scope of the literature assessing food insecurity and sexual risk behaviors among adolescents is limited, with the majority of quantitative and qualitative research focusing on food insecurity among the general adult population and their risk of STIs. Nevertheless, our findings demonstrate that food insecurity is associated with a heightened risk of engaging in sexual risk behaviors associated with the risk for adolescent pregnancy. However, the mechanism between food insecurity and sexual risk behaviors for teenage pregnancy will need further attention via future studies.
There were also findings that were not as expected. For example, studies examining adult populations have found associations between reported food insecurity and total sexual partners, particularly among women [27]. However, the results of the present study did not find an association between reported food insecurity and the number of sexual partners in a lifetime. This may be due to a younger study sample with little diversity in terms of the number of sexual partners compared to previous study samples. Additionally, we did not find an association between reported food insecurity and ever having vaginal or anal sex and having sex in the past six months after accounting for age. Due to only a subgroup reporting ever having sex (n = 63), this restricted sample size reduced statistical power to detect a significant association in the adjusted logistic regression model. Future studies should involve a larger sample size of sexually active adolescents of this age group.
There were several methodological limitations of this study that impacted the interpretation of the results. Data relied on self-reported responses, and due to the sensitivity and stigmatization of topics, these experiences may be underreported. Second, studies assessing food insecurity use a standardized measurement scale, such as the United States Department of Agriculture (USDA) Household Food Security Survey, although the current study used only three items from the scale to assess food insecurity. A shortened scale may overestimate and reflect more food insecurity in the sample than might be detected using the full scale. Additionally, this scale is not validated for solely adolescent use or to assess food insecurity in relation to male partner financial dependence. Third, because the sample population included adolescents in predominantly Latino communities aged 15–22 and did not precisely sample only those previously or in a current relationship with a boy/man, reports of sexual risk behaviors were low. A smaller sample size limits statistical power to detect significant associations, and, thus, non-significant findings should be interpreted with caution. Nonetheless, multiple statistically significant associations were found between food insecurity and multiple sexual risk behaviors. In addition, future studies are needed that will measure relationship status more comprehensively, including length of time in that relationship, as well as to better capture the types of relationships girls have with males they are depending on financially. The study findings are most generalizable to similar school-based samples of adolescent girls. Lastly, the current study is unable to claim a direct pathway of food insecurity causing sexual risk behaviors; longitudinal research is needed to understand the temporality of these associations.

5. Conclusions

Despite these limitations, the results pose significant implications for further research and intervention among this age group. This study contributes to the existing research on food insecurity as an important contributing factor in adverse sexual health outcomes among adolescents. Specifically, this study builds upon previous studies among Latina adolescents to demonstrate associations between economic vulnerability in girls’ lives, specifically food insecurity, in relation to adverse sexual risk behaviors linked to adolescent pregnancy. The current findings emphasize the importance of economic interventions to improve sexual health outcomes among adolescents. Our findings also suggest the need for sexual health and adolescent pregnancy programs to consider economic risk factors, including food insecurity and financial reliance on males, that may be playing a role in increasing vulnerability to adolescent pregnancy. Future studies are also needed to further improve measures for economic vulnerability among adolescents, as well as to provide an improved understanding of the economic factors that contribute to the disproportionate rates of adolescent pregnancy among U.S. Latina adolescents, particularly within the U.S.–Mexico border region. Future measures could include questions about participants’ current enrollment in food assistance programs that support low-income families (e.g., Supplemental Nutrition Assistance Program [SNAP]) or their eligibility for such programs. However, adolescents may not know their household financial status, making it difficult for them to determine their eligibility or know whether their household is already enrolled. Further research should closely examine the mechanism between food insecurity and engagement in sexual risk behaviors, with an emphasis on financial and other dependence on male partners, as well as assess other indicators of economic vulnerability (e.g., perceived economic hardship, living situation, family dynamics) in relation to the risk of adolescent pregnancy. Furthermore, our findings suggest that food insecurity should be considered another social determinant of health related to sexual risk behaviors for adolescent pregnancy among Latina adolescents.

Author Contributions

Conceptualization: G.X.A., N.T. and E.R.; Methodology: G.X.A., N.T. and E.R.; Validation: M.M. and E.R.; Formal analysis: M.M.; Data curation: M.M. and E.R.; Writing—original draft: M.M.; Writing—review & editing: M.M., G.X.A., E.S., N.T. and E.R.; Supervision: E.R.; Project administration: E.R. All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development under Grant R21 HD097496.

Institutional Review Board Statement

All procedures and measures were reviewed and approved by the San Diego State University Human Research Protection Program in October 2018 (HS-2018-0231).

Informed Consent Statement

All participants either provided consent to participate or, for those under 18, gave assent along with parental consent.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors on request.

Acknowledgments

We express sincere appreciation to the Girls Invest research team, local collaborators, and participants of the study.

Conflicts of Interest

The authors declare no conflicts of interest.

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Table 1. Sample characteristics and bivariate analysis by experience of food insecurity in the past month among U.S. Latina adolescents * (N = 187).
Table 1. Sample characteristics and bivariate analysis by experience of food insecurity in the past month among U.S. Latina adolescents * (N = 187).
Reported Food Insecurity
Demographic CharacteristicsTotal Sample
(N = 187)		Yes
(n = 90)		No
(n = 97)
n (%) n (%)n (%)p Value
Age 0.039
  15–17 years137 (73.2)59 (65.6)78 (80.4)
  18–20 years48 (25.7)29 (32.2)19 (19.6)
  21–22 years2 (1.0)2 (2.2)0 (0.0)
U.S. Born 0.693
  Yes169 (90.3)81 (90.0)88 (91.7)
  No17 (9.1)9 (10.0)8 (8.3)
Latina/Hispanic 0.265
  Yes159 (85.0)73 (83.0)86 (88.7)
  No26 (13.9)15 (17.0)11 (11.3)
Race 0.194
  American Indian or Alaska Native 11 (5.9)7 (8.6)4 (4.7)
  Asian6 (3.2)3 (3.7)3 (3.5)
  Black or African American13 (7.0)10 (12.3)3 (3.5)
  Native Hawaiian/Pacific Islander4 (2.1)1 (1.2)3 (3.5)
  White50 (26.7)20 (24.7)30 (35.3)
  Multiracial25 (13.3)10 (12.3)15 (17.6)
  Other57 (30.5)30 (37.0)27 (31.8)
Living Situation 0.007
  Live with both parents83 (44.4)33 (36.1)50 (51.5)
  Live only with mother61 (32.6)27 (30.3)34 (35.1)
  Other42 (22.4)29 (32.6)13 (13.4)
Employed 0.129
  Yes49 (26.2)28 (31.5)21 (21.6)
  No137 (73.3)61 (68.5)76 (78.4)
Relationship Status 0.664
  In a relationship47 (25.1)24 (30.4)23 (25.6)
  Dating or going out with someone17 (9.1)9 (11.4)8 (8.9)
  Hooking up13 (7.0)7 (8.9)6 (6.7)
  Not in a relationship92 (49.2)39 (49.4)53 (58.9)
Notes: * The sums in each column and row may not add up to n due to missing data.
Table 2. Food insecurity and relation to sexual risk behaviors for adolescent pregnancy: crude and adjusted logistic regression findings * (N = 187).
Table 2. Food insecurity and relation to sexual risk behaviors for adolescent pregnancy: crude and adjusted logistic regression findings * (N = 187).
Study Outcomes Reported Food Insecurity
Total Sample
(N = 187)		Yes
(n = 90)		No
(n = 97)		OR 95% Confidence Interval, p ValueAOR 95%
Confidence Interval, p Value
n (%)n (%)n (%)
Ever had vaginal or anal sex with a boy/man (lifetime)
  Yes72 (38.5)42 (46.2)30 (30.9)2.0 (1.1–3.6)1.7 (0.9–3.1) a
  No115 (61.5)48 (53.3)67 (69.1)
p = 0.027p = 0.114 a
Number of boys/men have had vaginal or anal sex with (lifetime)
  0–1147 (78.6)65 (78.3)82 (86.3)1.8 (0.8–3.8)1.4 (0.6–3.3) a
  2+31 (16.6)18 (21.7)13 (13.7)
p = 0.16p = 0.383 a
Early age of sexual initiation **
  <1423 (33.8)17 (44.7)6 (21.4)3.0 (1.0–9.0)3.6 (1.1–11.7) b
  15+43 (63.2)21 (55.3)22 (78.6)
p = 0.05p = 0.035 b
Sex (past 6 months)
  Yes63 (33.6)37 (41.6)26 (26.8)1.9 (1.1–3.6)1.7 (0.9–3.2) a
  No123 (65.8)52 (58.4)71 (73.2)
p = 0.034p = 0.111 a
Condom use (past 6 months) **
  Yes29 (49.2)11 (32.4)18 (72.0)0.2 (0.1–0.6)0.2 (0.1–0.6) a
  No30 (50.8)23 (67.6)7 (28.0)
p = 0.003p = 0.004 a
Contraceptive use (past 6 months) **
  Yes36 (57.1)21 (56.8)15 (57.7)1.0 (0.4–2.7)0.9 (0.3–3.1) c
  No27 (42.9)16 (43.2)11 (42.3)
p = 0.94p = 0.9 c
Dependence on a boyfriend or male partner for transportation
  Yes48 (25.7)28 (35.4)20 (21.7)2.0 (1.0–3.9)1.6 (0.7–3.6) d
  No123 (65.8)51 (64.6)72 (78.3)
p = 0.047p = 0.30 d
Financial dependence on a male partner
  Yes36 (19.3)28 (32.2)8 (8.6)5.0 (2.1–11.8)4.2 (1.6–11.3) e
  No144 (77.0)59 (67.8)85 (91.4)
p ≤ 0.001p = 0.004 e
Abbreviations: OR, odds ratio; AOR, adjusted odds ratio. Notes: Adjusted models include sample characteristics significantly associated (p < 0.05) with each outcome (e.g., ever had vaginal or anal sex with a boy/man [lifetime], number of boys/men have had vaginal or anal sex with [lifetime], early age of sexual initiation, sex in the past 6 months, condom use in the past 6 months, contraceptive use in the past 6 months, and financial and ride dependence on a male partner) variable. a Adjusted for age. b Adjusted for identifying as Hispanic/Latina. c Adjusted for current relationship status. d Adjusted for age and current relationship status. e Adjusted for employment and current relationship status. * The sums in each column and row may not add up to n due to missing data. ** Analyses assessing early age of sexual initiation, condom use and contraceptive use (past 6 months) were limited to those reporting having had sex in the past 6 months (n’s vary due to missing data).
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Mora, M.; Ayala, G.X.; Schmied, E.; Tang, N.; Reed, E. Economic Vulnerability and Associated Sexual Risk Factors for Adolescent Pregnancy Among Adolescent Females in Southern California. Adolescents 2025, 5, 35. https://doi.org/10.3390/adolescents5030035

AMA Style

Mora M, Ayala GX, Schmied E, Tang N, Reed E. Economic Vulnerability and Associated Sexual Risk Factors for Adolescent Pregnancy Among Adolescent Females in Southern California. Adolescents. 2025; 5(3):35. https://doi.org/10.3390/adolescents5030035

Chicago/Turabian Style

Mora, Mia, Guadalupe X. Ayala, Emily Schmied, Ning Tang, and Elizabeth Reed. 2025. "Economic Vulnerability and Associated Sexual Risk Factors for Adolescent Pregnancy Among Adolescent Females in Southern California" Adolescents 5, no. 3: 35. https://doi.org/10.3390/adolescents5030035

APA Style

Mora, M., Ayala, G. X., Schmied, E., Tang, N., & Reed, E. (2025). Economic Vulnerability and Associated Sexual Risk Factors for Adolescent Pregnancy Among Adolescent Females in Southern California. Adolescents, 5(3), 35. https://doi.org/10.3390/adolescents5030035

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