title: Physical and sexual violence, mental health indicators, and treatment seeking among street-based population groups in Tegucigalpa, Honduras.
abstract: OBJECTIVE
  To establish the prevalence of exposure to physical and sexual violence, mental health symptoms, and medical treatment-seeking behavior among three street-based subpopulation groups in Tegucigalpa, Honduras, and to assess the association between sociodemographic group, mental health indicators, and exposure to violence.
  
  
  METHODS
  An anonymous, cross-sectional survey among randomly selected street-based adolescents, adults, and commercial sex workers (CSWs) was undertaken at the end of 2010 in Tegucigalpa. Médecins Sans Frontières (MSF) mapped places where the study population gathers. Stratified probability samples were drawn for all groups, using two-stage random sampling. Trained MSF staff administered on-site standardized face-to-face questionnaires.
  
  
  RESULTS
  Self-reported exposure to severe physical violence in the previous year was 20.9% among street-based adolescents, 28.8% among adults, and 30.6% among CSWs. For the physical violence event self-defined as most severe, 50.0% of the adolescents, 81.4% of the adults, and 70.6% of the CSWs sought medical treatment. Their exposure to severe sexual violence was 8.6%, 28.8%, and 59.2%, respectively. After exposure to the self-defined most severe sexual violence event, 14.3% of adolescents, 31.9% of adults, and 29.1% of CSWs sought treatment. Common mental health and substance abuse symptoms were highly prevalent and strongly associated with exposure to physical (odds ratio 4.5, P < 0.0001) and sexual (odds ratio 3.7, P = 0.0001) violence.
  
  
  CONCLUSIONS
  Exposure to physical and sexual violence reached extreme levels among street-based subpopulations. Treatment-seeking behavior, particularly after severe sexual violence, was limited. The association of mental health and substance abuse symptoms with exposure to violence could lead to further victimization. Medical and psychological treatments targeting these groups are needed and could help decrease their vulnerability.
authors: Médecins Sans Frontières, México DF, México. javier.rio.navarro@geneva.msf.org
authors: Javier
authors: J
authors: Rio Navarro
authors: Julien
authors: J
authors: Cohen
authors: Eva
authors: E
authors: Rocillo Arechaga
authors: Edgardo
authors: E
authors: Zuniga
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D008603:Mental Health; D008875:Middle Aged; D017060:Patient Satisfaction; D015995:Prevalence; D011594:Psychometrics; D011902:Rape / Q000523:psychology* / Q000706:statistics & numerical data; D057566:Self Report; D011477:Sex Work / Q000523:psychology; D013223:Statistics as Topic; D013315:Stress, Psychological / Q000523:psychology*; D014505:Urban Population / Q000706:statistics & numerical data*; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult