Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA.
The REACH Initiative, Johns Hopkins School of Nursing, 525 N Wolfe St., Baltimore, MD, 21205, USA.
J Urban Health. 2019 Jun;96(3):469-476. doi: 10.1007/s11524-018-0238-6.
Experiences of coerced or forced sex have been associated with risk for HIV infection for all adults and may be more common for gays, lesbians, bisexuals (GLB) and people who inject drugs (PWID). In this study, we explored factors associated with prior 12-month experiences of forced or coerced sex among a sample of PWID, with a focus on sexual orientation and gender. PWID (N = 772) from Los Angeles and San Francisco were recruited using targeted sampling methods in 2011-2013 and surveyed on a range of items related to demographics, drug use, HIV risk, and violence, including experiences of forced or coerced sex in the prior 12 months. In this racially/ethnically diverse, mostly homeless, and low-income sample of PWID, 25% of participants were female and 15% identified as GLB. Sexual coercion was reported by 9% of gay and bisexual men, 8% of heterosexual females, 5% of lesbians and bisexual women, and less than 1% of heterosexual men. In multivariate analyses, compared to heterosexual males, gay or bisexual males (adjusted odds ratio [AOR] = 10.68; 95% confidence interval [CI] = 2.03, 56.23), and heterosexual females (AOR = 9.69; 95% CI = 2.04, 45.94) had increased odds of coerced sex in the prior 12 months. Having a paying sex partner (AOR = 3.49; 95% CI = 1.42, 8.54) or having had forced sex prior to the age of 16 by someone at least five years older (AOR = 4.74; 95% CI = 1.88, 11.93) also elevated the odds of coercive sex. Sexual coercion is common among PWID, but especially for gay and bisexual men and heterosexual females. Efforts to reduce sexual violence among PWID are urgently needed.
性强迫或性胁迫经历与所有成年人的 HIV 感染风险相关，对于男同性恋、女同性恋、双性恋者（GLB）和注射毒品者（PWID）来说可能更为常见。在这项研究中，我们探讨了性强迫或性胁迫经历与 PWID 群体中 12 个月前经历的关联因素，重点关注性取向和性别。2011 年至 2013 年，我们使用有针对性的抽样方法在洛杉矶和旧金山招募了 PWID 参与者，并对他们进行了一系列与人口统计、药物使用、HIV 风险和暴力相关的调查，包括过去 12 个月内的性强迫或性胁迫经历。在这个种族/民族多样化、大多数无家可归和低收入的 PWID 样本中，25%的参与者为女性，15%的参与者为 GLB。9%的男同性恋和双性恋男性、8%的异性恋女性、5%的女同性恋和双性恋女性报告了性胁迫，而不到 1%的异性恋男性报告了性胁迫。在多变量分析中，与异性恋男性相比，男同性恋或双性恋男性（调整后的优势比 [AOR] = 10.68；95%置信区间 [CI] = 2.03，56.23）和异性恋女性（AOR = 9.69；95% CI = 2.04，45.94）在过去 12 个月内更有可能经历强迫性行为。有付费性伴侣（AOR = 3.49；95% CI = 1.42，8.54）或在 16 岁之前被至少大 5 岁的人强迫发生性行为（AOR = 4.74；95% CI = 1.88，11.93）也会增加强迫性行为的几率。性胁迫在 PWID 中很常见，但在男同性恋和双性恋男性以及异性恋女性中更为常见。迫切需要努力减少 PWID 中的性暴力。
