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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.
Am J Epidemiol. 2015 May 15; 181(10):817-26.AJ

Abstract

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.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25834138

Citation

Tsai, Alexander C., et al. "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." American Journal of Epidemiology, vol. 181, no. 10, 2015, pp. 817-26.
Tsai AC, Weiser SD, Dilworth SE, et al. 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. Am J Epidemiol. 2015;181(10):817-26.
Tsai, A. C., Weiser, S. D., Dilworth, S. E., Shumway, M., & Riley, E. D. (2015). 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. American Journal of Epidemiology, 181(10), 817-26. https://doi.org/10.1093/aje/kwu350
Tsai AC, et al. 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. Am J Epidemiol. 2015 May 15;181(10):817-26. PubMed PMID: 25834138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Tsai,Alexander C, AU - Weiser,Sheri D, AU - Dilworth,Samantha E, AU - Shumway,Martha, AU - Riley,Elise D, Y1 - 2015/03/31/ PY - 2014/08/16/received PY - 2014/11/20/accepted PY - 2015/4/3/entrez PY - 2015/4/3/pubmed PY - 2015/7/15/medline KW - HIV KW - depressive disorder KW - partner violence KW - quality of life KW - rape SP - 817 EP - 26 JF - American journal of epidemiology JO - Am J Epidemiol VL - 181 IS - 10 N2 - 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. SN - 1476-6256 UR - https://www.unboundmedicine.com/medline/citation/25834138/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_ L2 - https://academic.oup.com/aje/article-lookup/doi/10.1093/aje/kwu350 DB - PRIME DP - Unbound Medicine ER -