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Um MY, Manikonda L, Eapen DJ, Ferguson KM, Maria DMS, Narendorf SC, Petering R, Barman-Adhikari A, Hsu HT. Predicting Intimate Partner Violence Perpetration Among Young Adults Experiencing Homelessness in Seven U.S. Cities Using Interpretable Machine Learning. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241263588. [PMID: 39045762 DOI: 10.1177/08862605241263588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Young adults experiencing homelessness (YAEH) are at higher risk for intimate partner violence (IPV) victimization than their housed peers. This is often due to their increased vulnerability to abuse and victimization before and during homelessness, which can result in a cycle of violence in which YAEH also perpetrates IPV. Identifying and addressing factors contributing to IPV perpetration at an early stage can reduce the risk of IPV. Yet to date, research examining YAEH's IPV perpetration is scarce and has largely employed conventional statistical approaches that are limited in modeling this complex phenomenon. To address these gaps, this study used an interpretable machine learning approach to answer the research question: What are the most salient predictors of IPV perpetration among a large sample of YAEH in seven U.S. cities? Participants (N = 1,426) on average were 21 years old (SD = 2.09) and were largely cisgender males (59%) and racially/ethnically diverse (81% were from historically excluded racial/ethnic groups; i.e., African American, Latino/a, American Indian, Asian or Pacific Islander, and mixed race/ethnicity). Over one-quarter (26%) reported IPV victimization, and 20% reported IPV perpetration while homeless. Experiencing IPV victimization while homeless was the most important factor in predicting IPV perpetration. An additional 11 predictors (e.g., faced frequent discrimination) were positively associated with IPV perpetration, whereas 8 predictors (e.g., reported higher scores of mindfulness) were negatively associated. These findings underscore the importance of developing and implementing effective interventions with YAEH that can prevent IPV, particularly those that recognize the positive association between victimization and perpetration experiences.
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Affiliation(s)
| | | | - Doncy J Eapen
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | | | | | | | - Hsun-Ta Hsu
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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2
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Lucea MB, Ramirez A, Martino N. Barriers to Seeking Healthcare Services After Sexual Assault: A Scoping Review. JOURNAL OF FORENSIC NURSING 2024:01263942-990000000-00093. [PMID: 38912876 DOI: 10.1097/jfn.0000000000000493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
BACKGROUND Sexual violence by an intimate partner or by a stranger remains highly prevalent in the United States. Yet, the use of post-sexual-assault health care is still underutilized. Persons in vulnerable populations such as immigrants, LGBTQIA+, and Black women may experience additional barriers to care. OBJECTIVE We sought to determine the extant research in this area, the methodologies used, and whether specific barriers exist for seeking sexual assault services. We sought to understand if barriers differed for vulnerable populations. INCLUSION CRITERIA Peer-reviewed literature published before September 2023, written in English, conducted in the United States, and that included survivors of sexual violence and explored barriers to seeking care postassault (i.e., sexual assault nurse examiners) were included in the review. METHODS Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews protocols were followed. PubMed, Scopus, CINAHL, PsycINFO, and PTSDpubs databases were used to identify literature that met the inclusion criteria, from which we selected 14 publications. RESULTS Much of the literature employed qualitative or mixed methods designs. Several studies focused on underserved minority groups, including immigrant women, Black women, and homeless youth. Common barriers existed on the intrapersonal, interpersonal, organizational, community, and societal levels. CONCLUSION The literature provided substantive context for the multilevel barriers, all contributing to survivors remaining silent rather than seeking much-needed help. Although there is a need for additional research on barriers to sexual assault services specifically, the extant research supports strengthening multilevel, alternative approaches to deliver much-needed services.
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Affiliation(s)
- Marguerite B Lucea
- Author Affiliations:Department of Nursing, College of Health Professions, Towson University
| | - Andrea Ramirez
- Department of Forensic Science, Fischer College of Math and Sciences, Towson University
| | - Natalie Martino
- Department of Audiology, College of Health Professions, Towson University
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3
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Montenegro M, Marcantonio T, Wiseblatt A. Prevalence and Variations of Sexual Violence Victimization Among US-Based Latino Adults and Adolescents: A Systematic Literature Review. JOURNAL OF SEX RESEARCH 2024; 61:811-824. [PMID: 38088800 PMCID: PMC11105995 DOI: 10.1080/00224499.2023.2291090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
Sexual violence victimization (SVV) is a significant public health concern. SVV research often focuses on college-attending White women's experiences, resulting in a knowledge gap regarding the experiences of ethnic minority groups, including the Latino community - the largest minority group in the US. To develop more culturally sensitive SV prevention efforts, the current study reviewed research focused on the prevalence rates of SVV among Latino people. The authors searched for published articles in PubMed, PsycINFO, and the reference sections of relevant articles published from 2011 to 2022. Articles were deemed eligible if they presented SVV prevalence rates for Latino participants; 39 articles were included in the review. The most frequently assessed aspect of SVV among Latino people was whether they had ever been victimized. The average prevalence rate across articles was 16.0%. Additionally, researchers examined the prevalence rates of unwanted touching, sexual coercion, and completed rape among Latino individuals. Few articles examined SVV prevalence rates among sexual and gender minority Latinos; those that did found higher SVV rates among those groups. SVV is a prevalent issue within the Latino community, with women and sexual minorities facing an even greater risk. Moving forward, studying the contextual factors of SVV among Latino people and developing culturally sensitive interventions tailored to this population are needed.
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Affiliation(s)
- María Montenegro
- Department of Spanish and Portuguese, Indiana University, Bloomington, IN, USA
| | - Tiffany Marcantonio
- Department of Health Science, The University of Alabama, Tuscaloosa, AL, USA
| | - Aria Wiseblatt
- Department of Psychology, University at Buffalo, SUNY, Buffalo, NY, USA
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Oesterle DW, McKee GB, Dworkin ER, Blackburn AM, Daigle LE, Gill-Hopple K, Gilmore AK. Characteristics of Sexual Assault Among Men Receiving a Forensic Medical Examination. JOURNAL OF CHILD SEXUAL ABUSE 2024; 33:337-354. [PMID: 37661816 PMCID: PMC10909921 DOI: 10.1080/10538712.2023.2249890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/09/2023] [Indexed: 09/05/2023]
Abstract
Sexual assault is a form of violence disproportionately perpetrated against women by men; however, men also experience high rates of sexual victimization. While recent research exploring victimization of sexual assault among men does exist, little is known about situational characteristics and consequences surrounding men's assault experiences. Therefore, the current study examines narratives of men's sexual assault to further understand the unique experiences of men receiving a sexual assault medical forensic examination. To accomplish this, we conducted a retrospective medical chart review of sexual assault narratives from N = 45 men receiving a sexual assault medical forensic examination at a large academic medical institution in the southeastern United States. Three general constructs were identified within the records: a) Perpetrator use of coercive tactics, b) Memory loss, and c) Contextual factors. Nested within these constructs, five specific themes emerged, including: a1) Use of weapons and physical force; a2) Tactical administration of alcohol and drugs; b1) Difficulties remembering assault; c1) Consensual sexual activity turned non-consensual; c2) Incarceration. Findings from the present study common identified characteristics of sexual assaults among men receiving a sexual assault medical forensic examination, including coercive tactics used by perpetrators, consequences of sexual assault, and high-risk settings for male victimization.
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Affiliation(s)
| | - Grace B McKee
- San Francisco VA Medical Center, San Francisco, CA, USA
| | - Emily R Dworkin
- University of Washington School of Medicine, Seattle, WA, USA
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Kwon SS, Jang Y, You JS, Lee CW, Yu H, Yoon J, Park YS, Ryoo HA, Lee D, Cho N, Ihm HK, Lee YC, Won HH, Kang HS, Ha TH, Myung W. Interpersonal sensitivity and childhood trauma in patients with major depressive disorder, bipolar I, and II disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:537-547. [PMID: 37195522 DOI: 10.1007/s00406-023-01619-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/04/2023] [Indexed: 05/18/2023]
Abstract
Childhood trauma and interpersonal sensitivity impact the development of mood disorders. In this study, we investigate the association between childhood trauma and interpersonal sensitivity in patients with mood disorders. A total 775 patients (major depressive disorder [MDD, n = 241], bipolar I disorder [BD I, n = 119], and bipolar II disorder [BD II, n = 415]) and 734 controls. For evaluation, we used the Childhood Trauma Questionnaire-Short Form (CTQ) and Interpersonal Sensitivity Measure (IPSM). We examined between-group differences for each subscale in the CTQ and IPSM. Patients with BD II had significantly higher IPSM total scores than patients with MDD, BD I, or controls. The CTQ total score was related to the IPSM total score in all participants and subgroups. Among the CTQ subscales, emotional abuse showed the highest correlation with the IPSM total score, while separation anxiety and fragile inner self showed higher positive correlations with CTQ than the other subscales of IPSM in all patient groups and the control group, respectively. The findings reveal that childhood trauma and interpersonal sensitivity are positively correlated among patients with MDD, BD I, and BD II, and that interpersonal sensitivity is higher in patients with BD II than those with BD I or MDD. Childhood trauma is associated with interpersonal sensitivity, and each trauma type has a different impact on mood disorders. We expect that this study will encourage future research on interpersonal sensitivity and childhood trauma in mood disorders to improve treatment approaches.
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Affiliation(s)
- Sarah Soonji Kwon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Yoonjeong Jang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
- Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Ji Seon You
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
- Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Chan Woo Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Yun Seong Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Hyun A Ryoo
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Nayoung Cho
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Hong Kyu Ihm
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Yeong Chan Lee
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Gonçalves Barbosa N, Carvalho Mendes LM, da Costa Carbogim F, Maria E Silva A, de Oliveira Gozzo T, Gomes-Sponholz FA. Sexual assault and vulnerability to sexually transmitted infections among homeless Brazilian women: a cross sectional qualitative study. BMC Womens Health 2023; 23:561. [PMID: 37907882 PMCID: PMC10617181 DOI: 10.1186/s12905-023-02723-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/20/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Homeless women have complex life conditions and are often exposed to violence, sexual exploitation, rape, prostitution, reproductive disorders, survival sex trading, unintended pregnancies and sexually transmitted infections (STIs). The aim was to explore the existence of sexual aggression and vulnerability to STIs among homeless Brazilian women. METHODS Fifteen interviews were conducted with homeless women who were admitted to a women's shelter in a large city in Brazil. Data were collected through semi-structured interviews, audiorecorded and complemented with notes of the researcher in field diary, subjected to inductive thematic analysis and analyzed in light of the social relations of gender. RESULTS Two themes were constructed: "Being a woman on the streets: a look at gender inequalities" and "Pain and the raped body: the scars of homeless women". The transgression of women's rights was observed with reports of sexual abuse interspersed with physical violence. Unprotected sexual practices were part of the daily lives of these women, with repercussions for their exposure to sexually transmitted infections. Dependence on psychoactive substances was mentioned, and transactional sex was used as a source of income to maintain such dependence, as well as to promote the women's livelihood. CONCLUSION Homeless women experience complex situations on the streets involving exposure to different types of violence, the use of transactional sex as a survival strategy and unprotected sexual practices. Furthermore, the way in which women have been exposed to sexual assault and their coping mechanisms to those require attention. Interventions are need to improve the healthcare assistance of homeless women victims of sexual assault, considering the vulnerability of this population.
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Affiliation(s)
- Nayara Gonçalves Barbosa
- Federal University of Juiz de Fora, Campus Universitãrio, Rua José Lourenço Kelmer, s/n - São Pedro, Juiz de Fora, 36036-900, Brazil.
| | - Lise Maria Carvalho Mendes
- University of São Paulo College of Nursing at Ribeirão Preto, Campus Monte Alegre, Avenida dos Bandeirantes 3900, Ribeirão Preto, 14040-902, SP, Brazil
| | - Fábio da Costa Carbogim
- Federal University of Juiz de Fora, Campus Universitãrio, Rua José Lourenço Kelmer, s/n - São Pedro, Juiz de Fora, 36036-900, Brazil
| | - Angela Maria E Silva
- Federal University of Rio de Janeiro, R. Afonso Cavalcanti, 275 - Cidade Nova, Rio de Janeiro, 20211-130, RJ, Brazil
| | - Thaís de Oliveira Gozzo
- University of São Paulo College of Nursing at Ribeirão Preto, Campus Monte Alegre, Avenida dos Bandeirantes 3900, Ribeirão Preto, 14040-902, SP, Brazil
| | - Flávia Azevedo Gomes-Sponholz
- University of São Paulo College of Nursing at Ribeirão Preto, Campus Monte Alegre, Avenida dos Bandeirantes 3900, Ribeirão Preto, 14040-902, SP, Brazil
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Wiener SJ, Porter JJ, Paydar-Darian N, Monuteaux MC, Hudgins JD. Emergency Care Utilization for Mental and Sexual Health Concerns Among Adolescents Following Sexual Assault: A Retrospective Cohort Study. J Adolesc Health 2023; 73:486-493. [PMID: 37294253 DOI: 10.1016/j.jadohealth.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE This study aimed to explore the health outcomes of adolescent survivors of sexual assault, as measured by subsequent emergency department (ED) utilization for mental and sexual health concerns. METHODS This retrospective cohort study used the Pediatric Health Information System (PHIS) database. We included patients aged 11-18 years seen at a PHIS hospital with a primary diagnosis of sexual assault. The control group included age- and sex-matched patients seen for an injury. Participants were followed in PHIS for 3-10 years; subsequent ED visits for suicidality, sexually transmitted infection, pelvic inflammatory disease (PID), or pregnancy were identified, and likelihoods of each were compared using Cox proportional hazards models. RESULTS The study population included 19,706 patients. ED return visit rates in the sexual assault and control groups were 7.9% versus 4.1% for suicidality, 1.8% versus 1.4% for sexually transmitted infection, 2.2% versus 0.8% for PID, and 1.7% versus 1.0% for pregnancy, respectively. Compared to controls, sexual assault patients were significantly more likely to return to the ED for suicidality throughout the follow-up period, with the highest hazard ratio of 6.31 (95% confidence interval 4.46-8.94) during the first 4 months. Sexual assault patients also had higher likelihood of returning for PID (hazard ratio 3.80, 95% confidence interval 3.07-4.71) throughout the follow-up period. DISCUSSION Adolescents seen in the ED for sexual assault were significantly more likely to return to the ED for suicidality and sexual health concerns, highlighting the need for increased allocation of research and clinical resources to improve their care.
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Affiliation(s)
- Susan J Wiener
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.
| | - John J Porter
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts
| | | | - Michael C Monuteaux
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Joel D Hudgins
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts
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Barbosa NG, Hasimoto TM, Michelon TM, Mendes LMC, dos Santos GG, Monteiro JCDS, Gomes-Sponholz FA. Attention to Women's Sexual and Reproductive Health at the Street Outreach Office. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10885. [PMID: 36078601 PMCID: PMC9517894 DOI: 10.3390/ijerph191710885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
The aim of study was to understand care strategies for homeless women, focusing on aspects of sexual and reproductive health from the perspective of Street Outreach Office strategy professionals. This is a qualitative study carried out in a large city in the countryside of São Paulo, Brazil. Data were collected from December 2020 to April 2021 through semi-structured interviews, and the results were obtained through content analysis and thematic modality. Nine health professionals participated in this study, and the analysis of the interviews allowed identifying three thematic categories: (i) being female and sex on the streets (violence and oppression); (ii) gynecology as a gateway to comprehensive care for homeless women; and (iii) pregnancy, puerperium and motherhood in the context of the streets. This study contributes to the reflection of professional practices within the Street Outreach Office, allowing the understanding of challenges in assisting homeless women, aiming to raise awareness of professionals and services that make up the health care network.
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Affiliation(s)
- Nayara Gonçalves Barbosa
- Department of Maternal-Child Nursing and Public Health, Faculty of Nursing, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil
| | - Thaís Massita Hasimoto
- Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-902, Brazil
| | | | - Lise Maria Carvalho Mendes
- Public Health Nursing Post-Graduate Program, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-902, Brazil
| | - Gustavo Gonçalves dos Santos
- Public Health Nursing Post-Graduate Program, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-902, Brazil
| | - Juliana Cristina dos Santos Monteiro
- Department of Maternal-Child Nursing and Public Health, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-902, Brazil
| | - Flávia Azevedo Gomes-Sponholz
- Department of Maternal-Child Nursing and Public Health, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-902, Brazil
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Damian AJ, Ponce D, Ortiz-Siberon A, Kokan Z, Curran R, Azevedo B, Gonzalez M. Understanding the Health and Health-Related Social Needs of Youth Experiencing Homelessness: A Photovoice Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9799. [PMID: 36011440 PMCID: PMC9408072 DOI: 10.3390/ijerph19169799] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 05/16/2023]
Abstract
PURPOSE Homelessness is a major public health problem facing millions of youths across the United States (U.S.), with lesbian gay, bisexual, transgender, questioning (LGBTQ+) youths and youths of color being disproportionately at higher risk. This study obtains an understanding of the health and health-related social needs of youths experiencing homelessness during the coronavirus disease (COVID-19) pandemic. METHODS A total of 14 youths between the ages of 14 and 24 who (a) lived, worked, or attended school in New Britain, Connecticut (CT) and (b) had at least one experience of homelessness or housing insecurity worked with the research team to conduct a needs assessment regarding youth homelessness. Using photovoice, a community-based participatory research method, participants created photo narratives to share their stories and recommendations for community change. The main goals of photovoice are to enable participants to (1) record and represent their everyday realities; (2) promote critical dialogue and knowledge about person and community strengths and concerns; and (3) reach policy makers. RESULTS Most of the participants identified as youths of color, and half of the participants identified as members of the LGBTQ+ community. Three major themes that appeared in the youths' narratives include the following: mental health and substance use challenges, trouble accessing basic human needs, and lack of a social support system. CONCLUSION This study uplifts and empowers a vulnerable population to increase visibility around a major public health challenge from their own lived experiences. Despite the challenges that were voiced, many participants shared a sense of hope and resiliency. The major themes endorsed by the youths has the potential of informing practitioners and policy makers of how to better address the needs of youths experiencing homelessness, particularly those most at risk.
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Affiliation(s)
- April Joy Damian
- Weitzman Institute, Community Health Center, Inc., 19 Grand Str., Middletown, CT 06457, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA
| | - Delilah Ponce
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA
| | - Angel Ortiz-Siberon
- Weitzman Institute, Community Health Center, Inc., 19 Grand Str., Middletown, CT 06457, USA
| | - Zeba Kokan
- Weitzman Institute, Community Health Center, Inc., 19 Grand Str., Middletown, CT 06457, USA
| | - Ryan Curran
- Weitzman Institute, Community Health Center, Inc., 19 Grand Str., Middletown, CT 06457, USA
| | - Brandon Azevedo
- Weitzman Institute, Community Health Center, Inc., 19 Grand Str., Middletown, CT 06457, USA
| | - Melanie Gonzalez
- Weitzman Institute, Community Health Center, Inc., 19 Grand Str., Middletown, CT 06457, USA
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Miles L, Valentine JL, Mabey L, Downing NR. Mental Illness as a Vulnerability for Sexual Assault: A Retrospective Study of 7,455 Sexual Assault Forensic Medical Examinations. JOURNAL OF FORENSIC NURSING 2022; 18:131-138. [PMID: 35045047 PMCID: PMC9415228 DOI: 10.1097/jfn.0000000000000361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Persons with severe mental illness (MI) are at a high risk of becoming victims of sexual assault (SA). Vulnerability for SA with any type of MI is unknown. This study aimed to identify the prevalence of preexisting MI and other significant factors in patients reporting preexisting MI at the time of their SA medical forensic examinations (SAMFEs). METHOD A retrospective SAMFE chart review of patients ( N = 7,455) from 2010 to 2020 was conducted. Sexual assault nurse examiners completed SAMFEs. Inclusion criteria included (a) aged 14 years and older, (b) completed SAMFE with SA kit evidence collection, and (c) reported to law enforcement (restricted cases not included). Descriptive statistics and chi-square analyses were completed. FINDINGS It was found that 46.7% of study participants reported preexisting MI and/or current use of psychotropic medications, more than double the MI prevalence rates in the general population. MI in patients seen for SAMFE was associated with prior history of SA, medical health problems, and physical or mental impairment. In addition, patients with MI reported more violent SAs with increased anogenital and nonanogenital injuries. DISCUSSION The high prevalence rate of any MI in patients seen for SAMFE indicates MI in varying severity is a significant vulnerability for SA. The association of preexisting MI with a history of SA, health problems, and physical or mental impairment expands understanding of associated MI factors. These findings support the development of interventions by healthcare providers and stakeholders to address SA vulnerabilities in individuals with MI.
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Affiliation(s)
| | | | - Linda Mabey
- Author Affiliations:Brigham Young University
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Du Mont J, Kosa SD, Macdonald S. Evaluation of an e-Learning Curriculum for Forensic Nurses on Trans-Affirming Postsexual Assault Care. Transgend Health 2022; 6:284-289. [PMID: 34988288 PMCID: PMC8664097 DOI: 10.1089/trgh.2020.0087] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Trans survivors of sexual assault have called for the development and implementation of training for care providers. To answer this call, we developed and evaluated an innovative e-learning curriculum for forensic nurses working across Ontario, Canada, on the provision of trans-affirming care. The e-learning curriculum, developed in Storyline 360 by Articulate, was launched in August 2019. The competence of nurses (N=65) completing the curriculum improved significantly from pre- to post-training across all content domains (Initial assessment, Medical care, Forensic examination, and Discharge and referral). This e-learning curriculum could be of utility in training forensic nurses worldwide.
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Affiliation(s)
- Janice Du Mont
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Daisy Kosa
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, Ontario, Canada
| | - Sheila Macdonald
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, Ontario, Canada
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Siconolfi D, Storholm ED, Vincent W, Pollack L, Rebchook GM, Huebner DM, Peterson JL, Kegeles SM. Prevalence and Correlates of Sexual Violence Experienced by Young Adult Black Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3621-3636. [PMID: 34725750 PMCID: PMC9473496 DOI: 10.1007/s10508-021-02011-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/27/2021] [Accepted: 04/09/2021] [Indexed: 05/06/2023]
Abstract
Men who have sex with men (MSM) experience high prevalence of sexual violence (SV), and SV has well-documented effects on health. Research gaps are especially evident for young Black MSM (YBMSM), who experience significant HIV disparities and syndemics, including multiple forms of violence victimization. We examined lifetime prevalence of SV (having been forced or frightened into sexual activity) in a cross-sectional sample of YBMSM (N = 1732), and tested associations of demographic, psychosocial, and structural factors using multivariable regression. YBMSM were recruited between 2013 and 2015 using modified venue-based time-location sampling (e.g., at bars and clubs) in Dallas and Houston, Texas. Approximately 17% of YBMSM experienced any SV in their lifetimes. SV was associated with high school non-completion (OR 1.78; 95% CI 1.15-2.77), lower psychological resilience (OR 0.84; 95% CI 0.71-0.98), lifetime history of homelessness (OR 5.52; 95% CI 3.80-8.02), recent financial hardship (OR 2.16; 95% CI 1.48-3.14), and recent transactional sex (OR 3.87; 95% CI 2.43-6.15). We also examined differences by age of SV onset (childhood versus adulthood). YBMSM with adolescent/emerging adult-onset SV may have been more ambivalent in reporting lifetime SV experience, compared to men with childhood-onset SV, and correlates differed by age of onset. Childhood-onset SV was associated with high school non-completion, lower levels of psychological resilience, history of homelessness, recent financial hardship, and recent transactional sex. Adolescent/emerging adult-onset SV was associated with greater depressive symptoms, history of homelessness, and recent financial hardship. There is a need for multi-level approaches to SV prevention and treatment, including services and supports that are culturally-relevant and responsive to the needs of YBMSM.
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Affiliation(s)
| | - Erik D Storholm
- RAND, Santa Monica, CA, USA
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
| | - Wilson Vincent
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Lance Pollack
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Gregory M Rebchook
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - David M Huebner
- Department of Prevention and Community Health, George Washington University, Washington, DC, USA
| | - John L Peterson
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Susan M Kegeles
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Wiener SJ, Fitzgerald S, Einhorn H. A trauma-informed guide to caring for adolescents following sexual assault. Curr Opin Pediatr 2021; 33:354-360. [PMID: 34039900 DOI: 10.1097/mop.0000000000001030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Sexual assault is common among adolescents worldwide. Survivors of sexual assault may experience various immediate and long-term effects on their physical and mental health. It is important that pediatric healthcare providers (HCPs) are aware of the high prevalence of sexual assault and recognize the impact on their adolescent patients. The aim of this update is to discuss how pediatric HCPs can embody a trauma-informed approach when caring for survivors of sexual assault across various settings. RECENT FINDINGS All adolescent patients should be screened for sexual assault during routine clinical visits; in responding to a disclosure, providers should exhibit compassion, express validation, and help connect the patient to resources to aid in healing. Caring for survivors of sexual assault should ideally be multidisciplinary, involving treatment of the medical complications (including the possibility of pregnancy or infection) and mental health sequelae (including increased likelihood of depression, posttraumatic symptoms, and suicidality). SUMMARY A trauma-informed approach can be applied to all aspects of caring for survivors of sexual assault, from screening for sexual assault and responding to disclosure, to providing acute and longitudinal care following sexual assault.
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Affiliation(s)
- Susan J Wiener
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
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14
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Santa Maria D, Lightfoot M, Nyamathi A, Businelle M, Paul M, Quadri Y, Padhye N, Jones J, Calvo Armijo M. A Nurse Case Management HIV Prevention Intervention (Come As You Are) for Youth Experiencing Homelessness: Protocol for a Randomized Wait-list Controlled Trial. JMIR Res Protoc 2021; 10:e26716. [PMID: 34018967 PMCID: PMC8178739 DOI: 10.2196/26716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/29/2021] [Accepted: 04/08/2021] [Indexed: 11/25/2022] Open
Abstract
Background Youth experiencing homelessness are more likely than housed youth to experience premature death, suicide, drug overdose, pregnancy, substance use, and mental illness. Yet while youth experiencing homelessness are 6 to 12 times more likely to become infected with HIV than housed youth, with HIV prevalence as high as 16%, many do not access the prevention services they need. Despite adversities, youth experiencing homelessness are interested in health promotion programs, can be recruited and retained in interventions and research studies, and demonstrate improved outcomes when programs are tailored and relevant to them. Objective The study aims to compare the efficacy of a nurse case management HIV prevention and care intervention, titled Come As You Are, with that of usual care among youth experiencing homelessness aged 16 to 25 years. Methods The study is designed as a 2-armed randomized wait-list controlled trial. Participants (n=450) will be recruited and followed up for 9 months after the intervention for a total study period of 12 months. Come As You Are combines nurse case management with a smartphone-based daily ecological momentary assessment to develop participant-driven HIV prevention behavioral goals that can be monitored in real-time. Youth in the city of Houston, Texas will be recruited from drop-in centers, shelters, street outreach programs, youth-serving organizations, and clinics. Results Institutional review board approval (Committee for the Protection of Human Subjects, University of Texas Health Science Center at Houston) was obtained in November 2018. The first participant was enrolled in November 2019. Data collection is ongoing. To date, 123 participants have consented to participate in the study, 89 have been enrolled, and 15 have completed their final follow-up. Conclusions There is a paucity of HIV prevention research regarding youth experiencing homelessness. Novel and scalable interventions that address the full continuum of behavioral and biomedical HIV prevention are needed. This study will determine whether a personalized and mobile HIV prevention approach can reduce HIV risk among a hard-to-reach, transient population of youth at high risk. International Registered Report Identifier (IRRID) DERR1-10.2196/26716
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Affiliation(s)
- Diane Santa Maria
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Marguerita Lightfoot
- Center for AIDS Prevention Studies and UCSF Prevention Research Center, University of California San Francisco, San Francisco, CA, United States
| | - Adey Nyamathi
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States
| | - Michael Businelle
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Mary Paul
- Baylor College of Medicine, Houston, TX, United States
| | - Yasmeen Quadri
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Nikhil Padhye
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jennifer Jones
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Margarita Calvo Armijo
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
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15
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Du Mont J, Hemalal S, Kosa SD, Cameron L, Macdonald S. The promise of an intersectoral network in enhancing the response to transgender survivors of sexual assault. PLoS One 2020; 15:e0241563. [PMID: 33206636 PMCID: PMC7673577 DOI: 10.1371/journal.pone.0241563] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 10/18/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study explores the promise of an intersectoral network in enhancing the response to transgender (trans) survivors of sexual assault. METHODS One hundred and three representatives of healthcare and community organizations across Ontario, Canada were invited to participate in a survey. Respondents were asked to: 1) identify systemic challenges to supporting trans survivors, 2) determine barriers to collaborating across sectors, and 3) indicate how an intersectoral network might address these challenges and barriers. Descriptive statistics were used to summarize quantitative data and qualitative data were collated thematically. RESULTS Sixty-seven representatives responded to the survey, for a response rate of 65%. Several themes capturing the challenges organizations face in supporting trans survivors were identified: Lack of knowledge and training among providers, Inadequate resources across organizations and institutions, and Limited access to and availability of appropriate services. Barriers to collaborating across sectors considered important by the overwhelming majority of respondents were: Lack of trans-positive service professionals (e.g., a paucity of sensitivity training), lack of resources (e.g., staff, staff time and workload, spaces to meet), and Institutional structures (e.g., oppressive policies, funding mandates). Four ways in which a network could address these challenges and barriers emerged from the data: Center the voices of trans communities in advocacy; Support competence of professionals to provide trans-affirming care; Provide the platform, strategies, and tools to aid in organizational change; and Create space for organizations to share ideas, goals, and resources. CONCLUSION Our findings deepen our understanding of important impediments to enhancing the response to trans survivors of sexual assault and the role networks of healthcare and community organizations can play in comprehensively responding to complex health and social problems.
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Affiliation(s)
- Janice Du Mont
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shilini Hemalal
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Sarah Daisy Kosa
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, ON, Canada
| | | | - Sheila Macdonald
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, ON, Canada
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Mont JD, Kosa SD, Hemalal S, Cameron L, Macdonald S. Formation of an intersectoral network to support trans survivors of sexual assault: A survey of health and community organizations. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 22:243-252. [PMID: 34240068 PMCID: PMC8118235 DOI: 10.1080/26895269.2020.1787911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND To address the growing international recognition of the inequities faced by transgender (trans) persons and the lack of services that attend to the specific concerns of trans sexual assault survivors, we undertook the development of an intersectoral network of hospital-based violence treatment centers and trans-positive community organizations to enhance available supports. AIMS To examine anticipated involvement of organizations in the network and determine network activities, deliverables, and values. METHODS We developed a survey with guidance from an advisory group of trans community members and their allies. Items on the survey related to network activities, deliverables, and values, which were also informed by key insights from earlier network planning meetings, were rated on a 5-point Likert scale for their importance (1 = not important at all, 5 = very important). RESULTS Sixty-four out of 93 organizations invited responded to the survey, giving a response rate of 69%. The highest prioritized network activities were: improve access to support services for trans survivors, educate trans survivors on their rights/what to expect when seeking supports and information on organizations, provide ongoing education/training for service providers on trans-affirming care, and inform guidelines on appropriate and sensitive standards of care/better practices for trans survivors (means = 4.6). The highest prioritized deliverables were: provision of standardized sensitivity training on violence against trans persons for professionals and development of an online directory/resource list of trans-affirming service providers and organizations that is continuously updated (means = 4.5). Trauma- and violence-informed and trans-guided were the most highly rated values (means = 4.8). CONCLUSION These findings have implications for healthcare and community leaders seeking to collaborate across sectors to address the inequities faced by trans persons experiencing sexual assault.
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Affiliation(s)
- Janice Du Mont
- Women’s College Research Institute, Women’s College Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sarah Daisy Kosa
- Women’s College Research Institute, Women’s College Hospital, Toronto, Canada
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, Canada
| | - Shilini Hemalal
- Women’s College Research Institute, Women’s College Hospital, Toronto, Canada
| | | | - Sheila Macdonald
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, Canada
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