Racial Disparities in Sexual Assault Characteristics and Mental Health Care After Sexual Assault Medical Forensic Exams.
Racial Disparities in Sexual Assault Characteristics and Mental Health Care After Sexual Assault Medical Forensic Exams.
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性侵犯特征的种族差异和性侵犯医学法医检查后的心理保健。
DOI：
10.1089/jwh.2020.8935
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Gilmore,AmandaK
中科院分区：
文献类型：
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作者：
Mosley,ElizabethA;Prince,JessicaR;McKee,GraceB;Carter,SierraE;Leone,RuschelleM;Gill-Hopple,Kathy;Gilmore,AmandaK
背景：性侵犯（SA）是常见的，但黑人个体可能具有更高的SA风险和负面健康后遗症。SA特征和SA后医疗保健利用的种族差异在很大程度上是未知的。材料和方法：我们回顾了在美国东南部一家医院接受SA医学法医检查（SAMFE）的690人（23.9%为黑人，93.6%为女性）的医疗记录。我们检查了SA特征的双变量种族差异，并使用零膨胀泊松回归来估计SAMFE医院心理健康门诊就诊的种族差异。结果：在SA幸存者中，黑人幸存者比白人幸存者更有可能受到亲密伴侣的伤害（优势比[OR] = 1.77，可信区间[95% CI] = 1.02-3.07），并且他们在SA后在SAMFE医院进行了更多的门诊心理健康访问（发病率比[IRR] = 2.05, 95% CI = 1.70-2.47）。黑人幸存者在SA前报告酒精或药物使用的可能性较小（or = 0.42, 95% CI = 0.28-0.62）。在多变量模型中，黑人幸存者比白人幸存者倾向于更多的心理健康就诊（IRR = 1.63, 95%CI = 0.82-2.44），但亲密伴侣暴力（IPV）显著调节了这一关联（IRR = 0.01, 95%CI =≤0.001-0.03）。被亲密伴侣袭击的黑人幸存者比白人IPV幸存者更不可能获得精神卫生保健。结论：SAMFE的医院环境可能是一个独特的机会，为黑人幸存者提供服务，减少心理健康后遗症的种族差异，但对于经历IPV的黑人幸存者来说，还需要额外的支持。一个交叉的生殖司法框架有可能解决这些挑战。
Background:Sexual assault (SA) is common, but Black individuals might be at higher risk of SA and negative health sequalae. Racial differences in SA characteristics and health care utilization after SA are largely unknown.Materials and Methods:We reviewed medical records of 690 individuals (23.9% Black; 93.6% women) who received a SA medical forensic exam (SAMFE) at a southeastern U.S. hospital. We examined bivariate racial differences in SA characteristics and used zero-inflated Poisson regressions to estimate racial differences in mental health outpatient visits at the SAMFE hospital.Results:Among survivors of SA, Black survivors were more likely than White survivors to have been victimized by an intimate partner (odds ratio [OR] = 1.77, confidence interval [95% CI] = 1.02–3.07) and they had more post-SA outpatient mental health visits at the SAMFE hospital (incidence rate ratio [IRR] = 2.05, 95% CI = 1.70–2.47). Black survivors were less likely to report alcohol or drug use before the SA (OR = 0.42, 95% CI = 0.28–0.62). In multivariable models, Black survivors trended toward more mental health visits than White survivors (IRR = 1.63, 95% CI = 0.82–2.44), but intimate partner violence (IPV) significantly moderated that association (IRR = 0.01, 95%CI = ≤0.001–0.03). Black survivors assaulted by an intimate partner were less likely to access mental health care than White IPV survivors.Conclusions:The hospital setting of a SAMFE could be a unique opportunity to serve Black survivors and reduce racial disparities in mental health sequelae, but additional support will be needed for Black survivors experiencing IPV. An intersectional, reproductive justice framework has the potential to address these challenges.