Polyvictimization and the Associations Between Poor Self-Perceived Health, Dissatisfaction With Life, and Sexual Dysfunction Among Women in Estonia

Abstract

The severe impact of different forms of violence on health has been demonstrated in a substantial number of studies. At the same time, it has been acknowledged that different forms of violence tend to co-occur, such that many survivors of violence have been exposed to more than one violent event and/or more than one form of violence. Despite mounting evidence concerning the associations between polyvictimization and health, there are still important gaps in this knowledge concerning adult female population's sexual health, including both physical and mental aspects associated with it. The aim of this study was to evaluate the exposure to emotional, physical, and sexual violence among women and associations with poor self-perceived health, dissatisfaction with life, stress, and worry due to sex life and sexual dysfunction. The term polyvictimization is used in this article to express the exposure to more than one form of violence. We used data from a cross-sectional study carried out in Estonia in 2014 among women aged 16 to 44 years. Responses of 2,333 women were analyzed for this article. Of all the respondents, 27.9% were polyvictimized. Women who had been exposed to all three forms of violence had, after adjusting for confounding factors, the highest risk of reporting poor self-perceived health, limited daily activities due to chronic health problems, feelings of depression, dissatisfaction with life, stress, and worry due to sex life and sexual dysfunction. The results of this study demonstrate that exposure to violence is associated with poorer health outcomes and that the association is stronger among those who have been polyvictimized.

What do we know about the impact of sexual violence on health and health behaviour of women in Estonia?

“…For sample size calculations, data from previous studies [23,24] regarding the percentage of sexually active respondents in each age group and total response rates were taken into account in order to get a sufficiently large sample. The initial sample size was 5233 women, and by age group the numbers were 2112 (16)(17), 1144 (18)(19)(20)(21)(22)(23)(24), 993 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and 984 (35)(36)(37)(38)(39)(40)(41)(42)(43)(44). For this calculation, the OpenEpi software package [25] was used.…”

“…Although the Soviet Union had its policies that seemingly promoted gender equality, violence against women was often ignored and remained undocumented [20]. More recently, however, there has been a steady increase in research looking at SV and other forms of violence against women [21,22].…”

What do we know about the impact of sexual violence on health and health behaviour of women in Estonia?

“…For sample size calculations, data from previous studies [23,24] regarding the percentage of sexually active respondents in each age group and total response rates were taken into account in order to get a sufficiently large sample. The initial sample size was 5233 women, and by age group the numbers were 2112 (16)(17), 1144 (18)(19)(20)(21)(22)(23)(24), 993 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and 984 (35)(36)(37)(38)(39)(40)(41)(42)(43)(44). For this calculation, the OpenEpi software package [25] was used.…”

“…Although the Soviet Union had its policies that seemingly promoted gender equality, violence against women was often ignored and remained undocumented [20]. More recently, however, there has been a steady increase in research looking at SV and other forms of violence against women [21,22]. Nevertheless, the impact of SV on Estonian women's health and sexual behaviours has not been studied, and the current study seeks to contribute to closing this gap.…”

What do we know about the impact of sexual violence on health and health behaviour of women in Estonia?  

“…For sample size calculations, data from previous studies [23,24] regarding the percentage of sexually active respondents in each age group and total response rates were taken into account in order to get a su ciently large sample. The initial sample size was 5233 women, and by age group the numbers were 2112 (16)(17), 1144 (18)(19)(20)(21)(22)(23)(24), 993 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and 984 (35)(36)(37)(38)(39)(40)(41)(42)(43)(44). For this calculation, the OpenEpi software package [25] was used.…”