Assessment of sexual violence among street females in Bahir-Dar town, North West Ethiopia: a mixed method study

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. CONCLUSION 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.