The Cedar Project: Historical trauma, sexual abuse and HIV risk among young Aboriginal people who use injection and non-injection drugs in two Canadian cities
The Cedar Project: Historical trauma, sexual abuse and HIV risk among young Aboriginal people who use injection and non-injection drugs in two Canadian cities
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DOI：
10.1016/j.socscimed.2008.03.034
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发表时间：
2008-06-01
影响因子：
5.4
通讯作者：
Spittal, Patricia M.
中科院分区：
文献类型：
--
作者：
Pearce, Margo E.;Christian, Wayne M.;Spittal, Patricia M.
最近的原住民学者将北美原住民的创伤性生活经历（包括性虐待）置于其作为殖民地人民地位的更大背景下进行研究。性虐待与许多负面健康后果有关，包括精神、性和毒品相关的脆弱性。加拿大很少有研究探讨原住民先前的性虐待与负面健康结果（包括艾滋病毒感染风险升高）之间的关系。这项研究的主要目的是确定与雪松项目参与者性虐待相关的因素，雪松项目是一群年龄在 14 至 30 岁之间的年轻原住民，他们在加拿大不列颠哥伦比亚省的两个城市中心使用注射和非注射毒品；并通过历史和代际创伤的镜头来寻找发现。我们在研究设计、问题提出和结果解释中运用了后殖民视角。使用多变量模型来确定性虐待史对负面健康结果和艾滋病毒感染脆弱性的预测程度。在 543 名符合资格的参与者中，48% 的人表示曾经经历过性虐待； 69% 的性虐待参与者是女性。女性和男性参与者首次遭受性虐待的中位年龄均为 6 岁。在调整了社会人口统计学变量和历史创伤因素后，遭受性虐待的参与者更有可能曾经在街上呆过三个晚上以上、曾经自残、有自杀意念、试图自杀、被诊断出患有精神疾病。过去 6 个月内曾到过急诊室，一生有 20 多个性伴侣，曾经有过性行为报酬，并且曾经服药过量。雪松项目参与者中性虐待的普遍性和后果令人严重关切。性创伤将继续影响个人、家庭和社区，直到未解决的历史创伤在以客户为导向、文化安全的项目中得到有意义的解决。 (C) 2008 Elsevier Ltd. 保留所有权利。
Recent Indigenist scholarship has situated high rates of traumatic life experiences, including sexual abuse, among Indigenous peoples of North America within the larger context of their status as colonized peoples. Sexual abuse has been linked to many negative health outcomes including mental, sexual and drug-related vulnerabilities. There is a paucity of research in Canada addressing the relationship between antecedent sexual abuse and negative health outcomes among Aboriginal people including elevated risk of HIV infection. The primary objectives of this study were to determine factors associated with sexual abuse among participants of the Cedar Project, a cohort of young Aboriginal people between the ages of 14 and 30 years who use injection and non-injection drugs in two urban centres in British Columbia, Canada; and to locate findings through a lens of historical and intergenerational trauma. We utilized post-colonial perspectives in research design, problem formulation and the interpretation of results. Multivariate modeling was used to determine the extent to which a history of sexual abuse was predictive of negative health outcomes and vulnerability to HIV infection. Of the 543 eligible participants, 48% reported ever having experienced sexual abuse; 69% of sexually abused participants were female. The median age of first sexual abuse was 6 years for both female and male participants. After adjusting for sociodemographic variables and factors of historical trauma, sexually abused participants were more likely to have ever been on the streets for more than three nights, to have ever self-harmed, to have suicide ideation, to have attempted suicide, to have a diagnosis of mental illness. to have been in the emergency department within the previous 6 months, to have had over 20 lifetime sexual partners, to have ever been paid for sex and to have ever overdosed. The prevalence and consequences of sexual abuse among Cedar Project participants are of grave concern. Sexual trauma will continue to impact individuals, families and communities until unresolved historical trauma is meaningfully addressed in client-driven, culturally safe programming. (C) 2008 Elsevier Ltd. All rights reserved.