Factors associated with self-report of sexual violence against men and women with mental disorders in Brazil

Abstract

Patients with mental illness (PMI) are more vulnerable to sexual violence (SV). This study aimed at assessing factors associated with SV against PMI, stratified by gender in Brazil. Cross-sectional multicenter study with a national sample of 2,475 PMI randomly selected from 26 psychiatric services. Odds ratios were estimated with 95% confidence interval using logistic regression. A high prevalence of lifetime SV against PMI was observed (19.8%) and it was higher among women (26.6%) than men (12.5%). Among women, episodes of SV were more often caused by intimate partners and in the domestic environment, and among men, by strangers and in the streets. Among women, the following variables were independently associated (p < 0.01) with SV: younger age, living alone, history of homelessness, previous psychiatric hospitalization, lifetime STD diagnosis, early debut of sexual intercourse, irregular condom use, receiving/offering money for sex, and psychiatric diagnosis. Among men, younger age, previous and earlier psychiatric hospitalization, lifetime illegal drug use, receiving/offering money for sex, and psychiatric diagnosis were independently associated with SV. The prevalence of SV in the studied population was high, especially among women. Women have more behavior factors associated with SV and they need protection, especially those in isolation and socially deprived. However, men also suffer SV, usually more often during childhood than adulthood and special attention should be given to lifetime illegal drug use and earlier psychiatric hospitalization. Preventive actions beyond mental health are important, such as social and economic actions to improve the living conditions of PMI.