Author/Authors :
Fallahi, Arezoo Kurdistan University of Medical Sciences, Sanandaj , Rahmani, Azam School of Nursing and Midwifery - Tehran University of Medical Sciences, Tehran , Azin, Ali graduate , Molavi, Nader Department of Addiction Studies - Faculty of Medicine - Kashan University of Medical Sciences, Kashan , Higgs, Peter Department of Public Health - La Trobe University - Melbourne, Australia , Allahqoli, Leila Iran University of Medical Sciences (IUMS), Tehran
Abstract :
Background: Homeless women are at high risk of sexually transmitted infections (STIs) due to their adverse early-life experiences.
Objectives: This study aimed to examine the association between adverse early-life experiences and the risk of acquiring STIsamong
homeless women in Tehran.
Patients and Methods: A descriptive-analytical cross-sectional study was carried out in 2014. The study recruited 241 homeless
women through quota sampling from the drop in centers and shelters affiliated to a local welfare organization in Tehran, Iran.
Data were obtained using questionnaires on demographics and adverse early-life experiences. Blood and urine samples were tested
for human immunodeficiency virus (HIV), herpes simplex virus 2 (HSV-2), syphilis, Chlamydia trachomatis, and Neisseria gonorrhea.
Descriptive statistics including frequency were calculated for all variables. To analyze the data at a significance level of 0.05, binary
logistic regression was used.
Results: The prevalence rates of HIV/AIDS, HSV-2, syphilis, Chlamydia trachomatis, and Neisseria gonorrhea were 8.29%, 23.65%, 14.93%,
11.61%, and 6.63%, respectively. The results of logistic regression showed that the risk of acquiring STIs increases by factors such as
sexual abuse (OR = 4.06; 95% CI = 1.21 - 13.6, P = 0.02), running away from home (OR = 4.46; 95% CI = 1.67 - 12.89, P = 0.03), drug use (OR
= 3.93; 95% CI = 1.13 - 13.58, P = 0.03), alcohol use (OR = 4.12; 95% CI = 1.38 - 12.24, P = 0.01), imprisonment and criminal records (OR =
2.72; 95% CI = 1.01 - 7.52, P = 0.04), premarital sexual activity (OR = 4.71; 95% CI = 1.06 - 13.84, P = 0.05), divorce (OR = 3.47; 95% CI = 1.06 -
11.32, P = 0.03), Nikah mut’ah (OR = 4.33; 95% CI = 1.39 - 13.49, P = 0.01), having multiple sex partners (OR = 5.2; 95% CI = 1.81 - 14.96, P =
0.02), and having unprotected sexual relationships (OR = 3.69; 95% CI = 1.00 - 13.62, P = 0.05).
Conclusions: Homeless women had high rates of adverse early-life experiences and overall 41.49% of them were affected at least by
one STI. Future interventions should focus on the reduction of adverse early-life experiences, especially during adolescence, including
the promotion of adolescent empowerment, promotion of condom use, and improvement of awareness of STIs.
Keywords :
Adverse Childhood Experiences , Adolescence , Homeless Persons , Women , Sexually Transmitted Diseases
