Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65015, Dar es Salaam, Tanzania.
Harm Reduct J. 2022 Jun 27;19(1):68. doi: 10.1186/s12954-022-00649-x.
Women who use heroin and other drugs (WWUD) are a key population with elevated risk of physical and sexual violence perpetrated by intimate partners and non-partners. While housing instability has been shown to be associated with violence in high-income settings, this is an underexplored topic in sub-Saharan Africa. In this research, we aimed to assess the relationship between housing instability and various forms of violence within a sample of WWUD in Dar es Salaam.
This analysis uses data from a parent study from 2018. A total of 200 WWUD were recruited through respondent-driven sampling methods and administered a survey. Two multivariable logistic regression models were built to assess the relationship between housing instability and physical violence (Model 1) and housing instability and sexual violence (Model 2) while controlling for a number of sociodemographic characteristics.
Approximately 35% of participants were classified as housing unstable. More than half of participants (62%) reported experiencing physical violence in the past 12 months, and more than a third (36%) reported sexual violence in the same time period. Housing instability was found to be independently associated with both physical and sexual violence victimization in the past year when adjusting for covariates (Model 1 adjusted odds ratio [AOR]: 2.40, 95% CI 1.22-4.46; Model 2 AOR: 1.93. 95% CI 1.02-3.67).
To our knowledge, this is the first study to document a significant association between housing instability and violence among WWUD communities in sub-Saharan Africa. This analysis adds to the growing body of literature on the relationship between stable housing and livelihood and health outcomes across differing populations. The cyclical nature of housing instability and violence may be disrupted through housing programming that provides safety, security, and stability for WWUD.
使用海洛因和其他毒品的女性（WWUD）是一个高危人群，她们面临着来自亲密伴侣和非伴侣的身体和性暴力的风险。虽然住房不稳定与高收入环境中的暴力有关，但这在撒哈拉以南非洲地区是一个研究不足的话题。在这项研究中，我们旨在评估达累斯萨拉姆的 WWUD 样本中住房不稳定与各种形式暴力之间的关系。
本分析使用了 2018 年一项母研究的数据。通过回应驱动抽样方法招募了 200 名 WWUD，并对其进行了调查。建立了两个多变量逻辑回归模型来评估住房不稳定与身体暴力（模型 1）和住房不稳定与性暴力（模型 2）之间的关系，同时控制了一些社会人口特征。
约 35%的参与者被归类为住房不稳定。超过一半的参与者（62%）报告在过去 12 个月内遭受过身体暴力，超过三分之一（36%）报告在同一时期遭受过性暴力。在调整协变量后，住房不稳定与过去一年的身体和性暴力受害独立相关（模型 1 调整后的优势比 [AOR]：2.40，95%CI 1.22-4.46；模型 2 AOR：1.93，95%CI 1.02-3.67）。
据我们所知，这是第一项记录撒哈拉以南非洲地区 WWUD 社区中住房不稳定与暴力之间显著关联的研究。这项分析增加了关于稳定住房与不同人群的生计和健康结果之间关系的不断增长的文献。通过为 WWUD 提供安全、保障和稳定的住房规划，可以打破住房不稳定和暴力的循环性质。
