title: Assessment of sexual violence among street females in Bahir-Dar town, North West Ethiopia: a mixed method study.
abstract: BACKGROUND
  Sexual violence is a major public health concern as well as human rights violation. Homeless women are far more likely to experience violence of all sorts than women in general. The objective of this study is to assess the prevalence and consequence of rape, and explore the reasons and factors associated with rape among street females in Bahir-Dar town, North West Ethiopia.
  
  
  METHODS
  This is a mixed method study which included: a survey of 395 street females age 15-49; key informant interview with 4 stakeholders; 5 case studies; one focus group of 10 street females and one focus group of 10 street males. Street females are those who spend most of their time on the street and who depend on the street for their life. Qualitative and quantitative data were assessed separately with thematic and statistical analysis respectively. Quantitative data was analyzed using SPSS version 16.0. Bivariate and Multivariate analysis were determined.
  
  
  RESULTS
  Life time prevalence of rape was 24.3% and the prevalence of rape in the last year was 11.4%. Factors like females "off" the street [OR (95% CI) =6.2 (3.0, 12.9)], being a prostitute [OR (95% CI) = 4.1 (1.5, 11.1)] and age 15-29 [OR (95% CI) =3.5 (1.1, 11.2)] were significantly associated with rape. Most, 93.8% of the rapes were not reported to legal bodies. None of the victims used condom during the rape event. Only, 4 (4.2%) of the victims used emergency contraceptive method following the rape event. Out of the total of 96 victims of rape, 13 (19.1%) and 9 (13.2%) experienced unwanted pregnancy and induced abortion respectively. Beside, 38 (41%) and 15 (22%) victims claimed genital injury and unusual vaginal discharge respectively. Psychological consequence like, hating others by 34 (35.8%), fear and concern for HIV/AIDS by 44 (46.6%), guilt feeling by 28 (29.4%) and loss of interest in sexual activity by 28 (29.4%) of victims were reported. Majority, 42.9% of victims attribute their victimization with sleeping in areas where there are many brothels. Being physically weak, long stay in street life, and sleeping around street males were reasons mentioned for rape by 11.9%, 29.7% and 15.4% of rape victims respectively.
  
  
  CONCLUSIONS
  In general, there is a very high prevalence of rape exacting significant physical and psychological tolls in victims of the study. Therefore, timely and integrated actions of the various stakeholders working in this area are crucial to curtail this critical human rights violation.
authors.affiliation: Clinical Trial Department, Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia. bestchale@yahoo.com.
authors.forename: Alemayehu C
authors.initials: AC
authors.lastname: Misganaw
authors.forename: Yalew A
authors.initials: YA
authors.lastname: Worku
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019548:Crime Victims / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005002:Ethiopia; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D011902:Rape / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012742:Sex Offenses / Q000706:statistics & numerical data*; D060386:Sex Workers / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012959:Socioeconomic Factors; D055815:Young Adult
references.citation: J Adolesc Health. 1998 Dec;23(6):370-7
references.pmid: 9870331
references.citation: Semin Pediatr Infect Dis. 2003 Jan;14(1):6-11
references.pmid: 12748916
references.citation: Lancet. 2002 Oct 5;360(9339):1083-8
references.pmid: 12384003
references.citation: Fam Plann Perspect. 1997 Sep-Oct;29(5):200-3, 227
references.pmid: 9323495
references.citation: Soc Sci Med. 1993 Sep;37(5):661-70
references.pmid: 8211280
references.citation: Soc Sci Med. 2001 Mar;52(5):733-44
references.pmid: 11218177
references.citation: Semin Pediatr Infect Dis. 2003 Jan;14(1):12-9
references.pmid: 12748917
references.citation: J Trauma Stress. 1999 Oct;12(4):587-99
references.pmid: 10646178
references.citation: Am J Public Health. 2006 Jan;96(1):132-8
references.pmid: 16317213
references.citation: Int J Gynaecol Obstet. 2006 Sep;94(3):325-32
references.pmid: 16842792
references.citation: Violence Against Women. 1998 Jun;4(3):262-90
references.pmid: 12296014
references.citation: Fam Plann Perspect. 1992 Jan-Feb;24(1):4-11, 19
references.pmid: 1601126