Médecins Sans Frontières, México DF, México.
Rev Panam Salud Publica. 2012 May;31(5):388-95. doi: 10.1590/s1020-49892012000500006.
To establish the prevalence of exposure to physical and sexual violence, mental health symptoms, and medical treatment-seeking behavior among three street-based subpopulation groups in Tegucigalpa, Honduras, and to assess the association between sociodemographic group, mental health indicators, and exposure to violence.
An anonymous, cross-sectional survey among randomly selected street-based adolescents, adults, and commercial sex workers (CSWs) was undertaken at the end of 2010 in Tegucigalpa. Médecins Sans Frontières (MSF) mapped places where the study population gathers. Stratified probability samples were drawn for all groups, using two-stage random sampling. Trained MSF staff administered on-site standardized face-to-face questionnaires.
Self-reported exposure to severe physical violence in the previous year was 20.9% among street-based adolescents, 28.8% among adults, and 30.6% among CSWs. For the physical violence event self-defined as most severe, 50.0% of the adolescents, 81.4% of the adults, and 70.6% of the CSWs sought medical treatment. Their exposure to severe sexual violence was 8.6%, 28.8%, and 59.2%, respectively. After exposure to the self-defined most severe sexual violence event, 14.3% of adolescents, 31.9% of adults, and 29.1% of CSWs sought treatment. Common mental health and substance abuse symptoms were highly prevalent and strongly associated with exposure to physical (odds ratio 4.5, P < 0.0001) and sexual (odds ratio 3.7, P = 0.0001) violence.
Exposure to physical and sexual violence reached extreme levels among street-based subpopulations. Treatment-seeking behavior, particularly after severe sexual violence, was limited. The association of mental health and substance abuse symptoms with exposure to violence could lead to further victimization. Medical and psychological treatments targeting these groups are needed and could help decrease their vulnerability.
在洪都拉斯特古西加尔巴的三个街头亚人群中，建立遭受身体和性暴力、心理健康症状和寻求治疗行为的流行率，并评估社会人口统计学群体、心理健康指标与暴力暴露之间的关系。
2010 年底，在特古西加尔巴对随机选择的街头青少年、成年人和商业性工作者（CSWs）进行了一项匿名、横断面调查。无国界医生组织（MSF）绘制了研究人群聚集的地点。对所有群体都使用两阶段随机抽样进行分层概率抽样。受过培训的 MSF 工作人员在现场管理标准化的面对面问卷。
自我报告的过去一年中，街头青少年的严重身体暴力暴露率为 20.9%，成年人的暴露率为 28.8%，CSWs 的暴露率为 30.6%。对于自我定义的最严重的身体暴力事件，50.0%的青少年、81.4%的成年人和 70.6%的 CSWs 寻求医疗。他们遭受严重性暴力的比例分别为 8.6%、28.8%和 59.2%。在遭受自我定义的最严重性暴力事件后，14.3%的青少年、31.9%的成年人和 29.1%的 CSWs 寻求治疗。常见的心理健康和药物滥用症状非常普遍，与身体（优势比 4.5，P < 0.0001）和性（优势比 3.7，P = 0.0001）暴力暴露密切相关。
街头亚人群中身体和性暴力的暴露程度达到了极端水平。寻求治疗的行为，特别是在遭受严重性暴力后，受到限制。心理健康和药物滥用症状与暴力暴露之间的关联可能导致进一步的受害。需要针对这些群体提供医疗和心理治疗，这可以帮助减少他们的脆弱性。
