Prevalence of Sexual Violence and its Association with Depression among Male and Female Patients with Risky Drug Use in Urban Federally Qualified Health Centers
Sexual violence (SV) is common; however, the prevalence of SV and its long term sequela vary geographically and among subpopulations within the USA. As such, the aims of this study are the following: (1) to determine the prevalence of SV, (2) to identify correlates of SV, and (3) to determine if SV is associated with depression among male and female risky drug users in urban Federally Qualified Health Centers (FQHCs) in Los Angeles. This study includes adult patients of five urban FQHCs who self-reported risky drug use. We identified survivors of SV and those experiencing depression through survey questions that queried, before or after age 18, “Were you ever sexually assaulted, molested or raped?” and with the RAND Mental Health Index (MHI-5). We utilized Pearson’s chi-square tests to assess predictors of SV and logistic regression to assess for an association between SV and depression. Data collection took place from February 2011 to November 2012. Of the 334 study patients, 49% of females and 25% of males reported surviving SV. Exposure to SV, (both before 18 years of age and after 18 years of age) was the strongest predictor of depression among men and women in this study (OR 4.7, p < 0.05). These data demonstrate that sexual violence is prevalent in this urban FQHC population and is strongly associated with depression. Providers should consider screening both men and women with risky drug use for SV while health systems should continue to align mental health and primary care services to appropriately care for these extremely vulnerable patients. Trial Registration Clinical Trials. gov ID NCT01942876, Protocol ID DESPR DA022445, http://www.clinicaltrials.gov
KeywordsInterpersonal violence FQHC Substance abuse Drug use Addiction Sexual violence Gender
We gratefully acknowledge the following, without whose support we could not have conducted this study: The National Institute on Drug Abuse of the US National Institutes of Health; the hard working clinicians and staff of our study clinics; the patients who were willing to offer time and energy to participate; and the medical directors of our study clinics: Maria Chandler, MD, MBA; Michael Eaton, PA; Paul Gregerson, MD, MBA; Michael Hochman, MD, MPH; Karen Lamp, MD; Elisa Nicholas, MD, MSPH; Jeni Robinson, MD; Sandra Pisano, PhD; and Martin Serota, MD. The project described was supported by the Research in Addiction Medicine Scholars (RAMS) Program R25DA033211
Compliance with Ethical Standards
The study sponsor did not have a role in study design, collection, analysis, interpretation of data, writing the report, nor in the decision to submit the report for publication.
No financial disclosures were reported by the authors of this paper.
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