Effects of Adverse Early-Life Experiences on Sexually Transmitted Infections Among Homeless Women

Abstract

Background: Homeless women are at high risk of sexually transmitted infections (STIs) due to their adverse early-life experiences. Objectives: This study aimed to examine the association between adverse early-life experiences and the risk of acquiring STIs among homeless women in Tehran. Patients and Methods: A descriptive-analytical cross-sectional study was carried out in 2014. The study recruited 241 homeless women through quota sampling from the drop in centers and shelters affiliated to a local welfare organization in Tehran, Iran. Data were obtained using questionnaires on demographics and adverse early-life experiences. Blood and urine samples were tested for human immunodeficiency virus (HIV), herpes simplex virus 2 (HSV-2), syphilis, Chlamydia trachomatis, and Neisseria gonorrhea. Descriptive statistics including frequency were calculated for all variables. To analyze the data at a significance level of 0.05, binary logistic regression was used. Results: The prevalence rates of HIV/AIDS, HSV-2, syphilis, Chlamydia trachomatis, and Neisseria gonorrhea were 8.29%, 23.65%, 14.93%, 11.61%, and 6.63%, respectively. The results of logistic regression showed that the risk of acquiring STIs increases by factors such as sexual abuse (OR = 4.06; 95% CI = 1.21 - 13.6, P = 0.02), running away from home (OR = 4.46; 95% CI = 1.67 - 12.89, P = 0.03), drug use (OR = 3.93; 95% CI = 1.13 - 13.58, P = 0.03), alcohol use (OR = 4.12; 95% CI = 1.38 - 12.24, P = 0.01), imprisonment and criminal records (OR = 2.72; 95% CI = 1.01 - 7.52, P = 0.04), premarital sexual activity (OR = 4.71; 95% CI = 1.06 - 13.84, P = 0.05), divorce (OR = 3.47; 95% CI = 1.06 - 11.32, P = 0.03), Nikah mut’ah (OR = 4.33; 95% CI = 1.39 - 13.49, P = 0.01), having multiple sex partners (OR = 5.2; 95% CI = 1.81 - 14.96, P = 0.02), and having unprotected sexual relationships (OR = 3.69; 95% CI = 1.00 - 13.62, P = 0.05). Conclusions: Homeless women had high rates of adverse early-life experiences and overall 41.49% of them were affected at least by one STI. Future interventions should focus on the reduction of adverse early-life experiences, especially during adolescence, including the promotion of adolescent empowerment, promotion of condom use, and improvement of awareness of STIs.