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首页> 外文期刊>American Journal of Epidemiology >Violent Victimization, Mental Health, and Service Utilization Outcomes in a Cohort of Homeless and Unstably Housed Women Living With or at Risk of Becoming Infected With HIV
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Violent Victimization, Mental Health, and Service Utilization Outcomes in a Cohort of Homeless and Unstably Housed Women Living With or at Risk of Becoming Infected With HIV

机译：在无家可归者和居住不稳的妇女中，遭受艾滋病毒感染或有感染艾滋病毒风险的暴力受害，心理健康和服务利用结果

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Most studies about the association between exposure to violence and higher psychological vulnerability have been cross-sectional in nature. Using longitudinal data from the Shelter, Health, and Drug Outcomes Among Women Study on 300 homeless or unstably housed women infected with or at risk of becoming infected with human immunodeficiency virus who were living in San Francisco, California, in 2008-2012, we examined the relationship between recent violent victimization and mental health status, mental health-related emergency department visits, and psychiatric hospitalization. We used generalized estimating equations to account for potentially confounding time-invariant and time-varying variables, including comorbid psychiatric conditions and lifetime history of child abuse. A total of 207 (69%) women experienced childhood abuse. The median number of psychiatric diagnoses per woman at baseline was 8 (interquartile range, 5-11). Recent exposure to violence was associated with lower mental health status (b = -1.85, 95% confidence interval: -3.02, -0.68) and higher risks of mental health-related emergency department visits (adjusted risk ratio = 2.96, 95% confidence interval: 1.51, 5.78) and psychiatric hospitalizations (adjusted risk ratio = 2.32, 95% confidence interval: 1.10, 4.91). We did not find strong evidence of a reciprocal relationship. Among homeless or unstably housed women with severe preexisting comorbid psychiatric conditions, recent violence has adverse mental health consequences. Reducing ongoing violence may improve mental health in this population.
机译：关于暴力暴露与较高的心理脆弱性之间关系的大多数研究本质上都是横断面的。我们使用妇女住所，健康和药物结局研究的纵向数据，对2008-2012年居住在加利福尼亚州旧金山的300名无家可归或居住不稳定的妇女感染了人类免疫缺陷病毒或可能感染人类免疫缺陷病毒的妇女进行了研究。最近的暴力受害者与心理健康状况，与心理健康相关的急诊科就诊以及精神病住院之间的关系。我们使用广义估计方程来说明可能混淆的时不变和时变变量，包括合并症，精神病和虐待儿童的终生史。共有207名（69％）妇女经历了童年时代的虐待。每位女性在基线时的精神病诊断中位数为8（四分位间距为5-11）。最近遭受暴力侵害与较低的心理健康状况（b = -1.85，95％置信区间：-3.02，-0.68）和与精神卫生相关的急诊科就诊的风险较高（调整后的风险比= 2.96，95％置信区间）有关：1.51、5.78）和精神病住院（调整后的风险比= 2.32、95％置信区间：1.10、4.91）。我们没有找到相互关系的有力证据。在患有严重的既往合并精神病的无家可归者或居住不稳的妇女中，最近的暴力行为会对心理健康造成不利影响。减少持续的暴力行为可能会改善该人群的心理健康。

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