Medical Profile of Women Veterans Administration Outpatients Who Report a History of Sexual Assault Occurring While in the Military

Abstract

To profile differences in current physical symptoms and medical conditions among women users of Veterans Administration (VA) health services with and without a self-reported history of sexual assault sustained during military service, we conducted a cross-sectional analysis of a nationally representative, random sample of women veterans using VA outpatient services (n = 3632). A self-administered, mailed survey asked whether women had sustained sexual assault while in the military and requested information about a spectrum of physical symptoms and medical conditions. A history of sexual assault while in the military was reported by 23% of women VA users and was associated with current physical symptoms and medical conditions in every domain assessed. For example, women who reported sexual assault were more likely to indicate that they had a "heart attack" within the past year, even after adjusting for age, hypertension, diabetes, and smoking history (OR 2.3, 95% CI 1.3-4.0). Among women reporting a history of sexual assault while in the military, 26% endorsed > or = 12 of 24 symptoms/conditions, compared with 11% of women with no reported sexual assault while in the military (p < 0.001). Clinicians need to be attuned to the high frequency of sexual assault occurring while in the military reported by women VA users and its associated array of current physical symptoms and medical conditions. Clinicians should consider screening both younger and older patients for a sexual violence history, especially patients with multiple physical symptoms.

The relationship between sexual and physical abuse and substance abuse consequences

“…The fact that in both men and women physical consequences were worse in those who experienced abuse is consistent with literature on medical problems among women with trauma and substance abuse (Frayne et al, 1999;Koss, Koss, & Woodruff, 1991;Liebschutz, Feinman, Sullivan, Stein, & Samet, 2000;Liebschutz, Mulvey, & Samet, 1997). Both men and women with past trauma also experienced worse interpersonal relationship consequences of substance use.…”

Effects of Military Trauma Exposure on Women Veterans’ Use and Perceptions of Veterans Health Administration Care

“…7 Women with a history of sexual assault report more physical health complaints [8][9][10] and are more frequent users of health care. 9,11 Similar findings have been observed for women veterans who use VHA care.…”

“…9,11 Similar findings have been observed for women veterans who use VHA care. 7,[12][13][14] Research has also shown that female survivors of military sexual assault often experience more distrust and blame directed at medical staff, depression/anxiety, and reduced willingness to seek further help at military/VHA health care settings compared to women who have sought treatment for sexual assault at civilian facilities. 15 However, few studies have addressed how the experience of military sexual assault affects perceptions of specific health care-related dimensions (e.g., perceptions of medical professionals, characteristics of the health care setting) that may influence women veterans' use and satisfaction with VHA care.…”

Toward a VA women’s health research agenda: Setting evidence-based priorities to improve the health and health care of women veterans

“…[2][3][4][5][6] ; studies of the impact of military environmental exposure on reproductive outcomes among U.S. women Vietnam veterans 7,8 ; the first national assessment of the health status and effects of military service on self-reported health among women veterans who use VA ambulatory care [9][10][11][12][13] ; analyses of the large survey of veterans, which included over 30,000 women veterans 14 ; and an evaluation of the surgical risks and outcomes of women treated in VA hospitals. [15][16][17] Table 3 presents highlights of recent VA Women's Health Research.…”