Search for a command to run...
Abstract Background Literature on sexual assault prevalence among homeless women is limited, with few studies disaggregating risk by geography, resource access, mental health, LGBTQ status, or disability. Objective This study provides two distinct meta-analyses to ascertain the aggregated overall prevalence (k=20 studies) and the aggregated 12-month prevalence (k=14 studies) of sexual assault among homeless women. By examining each recall period independently, we elucidate cumulative burden throughout the life cycle and annual risk, offering unique insights for public health interventions. By synthesizing global data, we aimed to clarify risks for women with disabilities, mental illness, or Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Plus (LGBTQ+) identities to inform crisis care interventions. Methods Following PRISMA 2020 guidelines, six databases were searched for studies published after 2010 reporting sexual assault prevalence in homeless women. Twenty studies met the inclusion criteria. Random-effects meta-analyses were performed using a logit transformation. Heterogeneity was assessed with I² and Cochran’s Q; publication bias with funnel plots and Egger’s test. Results The pooled lifetime prevalence of sexual assault was 39.2 % (95 % CI 25–56 %), and 12-month prevalence was 22 % (95 % CI 16–30 %). Heterogeneity was extreme (I² = 97 %). Subgroup analyses showed the highest prevalence among women with disabilities (92 %, single study), followed by LGBTQ+ (33 %) and women with mental illness (34 %). HIV-positive women had the lowest prevalence (2.6 %). Egger’s test indicated no publication bias (p = 0.64). Conclusion Homeless women face disproportionately high rates of sexual assault, far exceeding the general female population, with particularly elevated estimates among women with disabilities, LGBTQ+ women, and those with mental illness. These preliminary findings highlight the need for improved screening practices and tailored public health interventions to address sexual assault in doubly vulnerable populations. Standardizing definitions of sexual assault and investigating risk factors could lead to more tailored public health interventions. Highlights Marked Epidemiologic Burden: Nearly 40% of homeless women report lifetime sexual assault. Persistent risk: One in five homeless women assaulted within the past 12 months. Marginalized Impact: Rates highest among disabled, LGBTQ+, and HIV+ women. High Variability: Extreme heterogeneity (I² ≈ 97%) shows research inconsistency. Research Priority: Standardize methods and definitions to improve accuracy.