Kushel Margot B, Evans Jennifer L, Perry Sharon, Robertson Marjorie J, Moss Andrew R
Division of General Internal Medicine, University of California, San Francisco/San Francisco General Hospital, University of California, San Francisco, CA 94143, USA.
Arch Intern Med. 2003 Nov 10;163(20):2492-9. doi: 10.1001/archinte.163.20.2492.
Homeless persons experience high rates of sexual and physical assault; homeless women are thought to be at highest risk. To determine the prevalence, distribution, and factors associated with sexual and physical assault, we surveyed homeless and marginally housed adults in San Francisco, Calif.
We interviewed 2577 respondents about their history of recent sexual and physical assault, housing history, sexual practices, substance use, health status, and criminal justice history. The main outcome measures were self-reported sexual and physical assault in the previous 12 months.
Overall, 32.3% of women, 27.1% of men, and 38.1% of transgendered persons reported a history of either sexual or physical assault in the previous year; 9.4% of women, 1.4% of men, and 11.9% of transgendered persons reported sexual assault, and 30.6% of women, 26.6% of men, and 33.3% of transgendered persons reported physical assault. In multivariate models, being homeless (as opposed to marginally housed) was associated with sexual assault for women, but not for men (adjusted odds ratio for homeless women, 3.4 [1.2-9.7]). Housing status was not associated with physical assault for women or men. Mental illness and sex work were both common and associated with high rates of assault in multivariate analyses.
Sexual and physical assault are common experiences for homeless and marginally housed persons. Housing is associated with lower rates of sexual assault among women. Strategies to decrease sexual and physical assault and its consequences are needed in this population.
无家可归者遭受性侵犯和身体暴力的比例很高；无家可归的女性被认为风险最高。为了确定性侵犯和身体暴力的患病率、分布情况以及相关因素，我们对加利福尼亚州旧金山的无家可归者和居住条件差的成年人进行了调查。
我们采访了2577名受访者，询问他们近期的性侵犯和身体暴力史、住房史、性行为、物质使用情况、健康状况以及刑事司法史。主要结局指标是过去12个月内自我报告的性侵犯和身体暴力情况。
总体而言，32.3%的女性、27.1%的男性和38.1%的跨性别者报告在过去一年中有性侵犯或身体暴力史；9.4%的女性、1.4%的男性和11.9%的跨性别者报告遭受过性侵犯，30.6%的女性、26.6%的男性和33.3%的跨性别者报告遭受过身体暴力。在多变量模型中，无家可归（相对于居住条件差）与女性的性侵犯有关，但与男性无关（无家可归女性的调整优势比为3.4 [1.2 - 9.7]）。住房状况与女性或男性的身体暴力无关。在多变量分析中，精神疾病和性工作都很常见，且与高比例的暴力行为有关。
性侵犯和身体暴力是无家可归者和居住条件差的人的常见经历。住房与女性较低的性侵犯发生率有关。需要针对这一人群制定减少性侵犯和身体暴力及其后果的策略。
